NPIMap

Organization Active NPI

Medical Personnels Services Inc.

  • Nursing Care Agency
  • Tampa, FL
National Provider Identifier
1285754671
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
30211120 Issued in FL
Legal business name
MEDICAL PERSONNELS SERVICES INC.
Practice address
4507 N Habana Ave
Tampa, FL 33614-7225
Phone
(813) 598-7268
Fax
(813) 872-2616
NPI assigned
Mar 30, 2007
Last updated
Dec 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Authorized official

Name
Mr. Remy Ogunsola
Title
Assistanat Administrator
Phone
(813) 598-4262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 30211120 FL Primary

Addresses

Primary practice location

4507 N Habana Ave
Tampa, FL 33614-7225

Mailing address

4507 N Habana Ave
Tampa, FL 33614-7225
Phone (813) 598-7268

Other identifiers 2

IdentifierTypeStateIssuer
651836200MedicaidFL
686487296MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081224000331 FL Part A Provider - Home Health Agency 7315009495 Practice locations: Tampa, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285754671. Details of each certification follow.

Home health agency certification: CCN 109385

Legal name
MEDICAL PERSONNELS SERVICES INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 23, 2009
Last certification
Jan 22, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 25, 2002 in FL
Enrollment address
4507 Habana Ave
Tampa, FL 33614-7225

Care Compare: Home health agency

Medicare Care Compare
Listed as
Medical Personnels Services IncCCN 109385 · All quality measures
Ownership
Proprietary
Certified
Jul 23, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1096713Medical Personnels Services Inc4507 Habana Ave, Tampa, FL 33614Certificate of waiverMar 9, 2027

National Provider Directory

National Provider Directory

Locations

4507 N Habana Ave
Tampa, FL 33614
Phone (813) 523-6385

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Grace Ogunsola Individual 5% Or Greater Direct Ownership InterestAdministrator Sep 22, 2008 50%
General Partnership Interest Sep 22, 2008
Corporate Director Sep 22, 2008
W-2 Managing Employee Sep 22, 2008
Stephen Ogunsola Individual Contracted Managing EmployeeCfo Sep 22, 2008 50%
5% Or Greater Direct Ownership InterestCfo Sep 22, 2008 50%
5% Or Greater Indirect Ownership InterestCfo Sep 22, 2008 50%
5% Or Greater Mortgage InterestCfo Sep 22, 2008 50%
5% Or Greater Security InterestCfo Sep 22, 2008 50%
General Partnership InterestCfo Sep 22, 2008 50%
Limited Partnership InterestCfo Sep 22, 2008 50%
Corporate OfficerCfo Sep 22, 2008 50%
Corporate DirectorCfo Sep 22, 2008 50%
W-2 Managing EmployeeCfo Sep 22, 2008 50%
Operational/Managerial ControlCfo Sep 22, 2008 50%
OtherCfo Sep 22, 2008 50%

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1285754671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147225",
            "telephone_number": "813-598-7268",
            "fax_number": "813-872-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147225",
            "telephone_number": "813-598-7268",
            "fax_number": "813-872-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PERSONNELS SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "OGUNSOLA",
        "authorized_official_first_name": "REMY",
        "authorized_official_title_or_position": "ASSISTANAT ADMINISTRATOR",
        "authorized_official_telephone_number": "813-598-4262",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "30211120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "651836200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686487296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.