NPIMap

Organization Active NPI

Oswego Health Home Care LLC..

  • Home Health Agency
  • Fulton, NY
National Provider Identifier
1285639625
Registry record updated Apr 12, 2024
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Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
3701600 Issued in NY
Legal business name
OSWEGO HEALTH HOME CARE LLC..
Practice address
510 S 4TH St
Fulton, NY 13069-2951
Phone
(315) 598-1544
NPI assigned
Jun 14, 2005
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OSWEGO HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric T Campbell
Title
Cfo
Phone
(315) 349-5531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 3701600 NY Primary

Addresses

Primary practice location

510 S 4TH St
Fulton, NY 13069-2951

Mailing address

510 S 4TH St
Fulton, NY 13069-2951
Phone (315) 598-1544

Other identifiers 1

IdentifierTypeStateIssuer
01238384MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141218000741 NY Part A Provider - Home Health Agency 6406179761 Practice locations: Fulton, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285639625. Details of each certification follow.

Home health agency certification: CCN 337284

Legal name
OSWEGO HEALTH HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 19, 1991
Last certification
May 7, 2019
Ownership / control type
Proprietary
Organization structure
LLCNon-profit
Incorporated
Jul 1, 2015 in NY
Enrollment address
510 S 4TH St
Fulton, NY 13069-2951
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Oswego Health Home Care, LLCCCN 337284 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Apr 19, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

113 Schuyler St
Fulton, NY 13069
Phone (315) 602-4275

113 Schuyler St
Ste 3
Fulton, NY 13069
Phone (315) 598-1544

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Backus Individual Corporate DirectorBoard Member Feb 23, 2022
Michael Harlovic Individual Corporate OfficerPresident and Ceo Sep 1, 2021
Jason Santiago Individual Corporate Director Jan 1, 2021
Eric T Campbell Individual Corporate DirectorBoard Member and Cfo Jul 1, 2020
Oswego Health Inc Organization, Oswego, NY Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%
Valerie Favata Individual Contracted Managing EmployeeAdministrator Jan 1, 2021

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 31

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1285639625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S 4TH ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692951",
            "telephone_number": "315-598-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S 4TH ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130692951",
            "telephone_number": "315-598-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSWEGO HEALTH HOME CARE LLC..",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSWEGO HEALTH",
        "enumeration_date": "2005-06-14",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "315-349-5531"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "3701600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01238384",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

Verify at the official NPI Registry.