American Prime Healthcare, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AMERICAN PRIME HEALTHCARE, INC.

Doing business as

KH Prime Hospice Care

Practice address

2180 Harvard St Ste 330
Sacramento, CA 95815-3317

Phone

(916) 418-4232

Fax

(916) 418-4289

NPI assigned

Aug 14, 2021

Last updated

Dec 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Hussam Kujok, MDNPI 1013081611

Title

President

Phone

(916) 418-4232

Specialties & licenses 1

Addresses

Other names 1

• KH Prime Hospice Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295400869. Details of each certification follow.

• CCN B41742 Hospice · Active · Details

Hospice certification: CCN B41742

Legal name

AMERICAN PRIME HEALTHCARE INC

Doing business as

KH PRIME HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 7, 2022

Last certification

Oct 6, 2022

Organization structure

CorporationProprietary

Incorporated

Oct 1, 2020 in CA

Enrollment address

2180 Harvard St
Ste 330
Sacramento, CA 95815-3317

Listed as

KH Prime Hospice CareCCN B41742 · All quality measures

Certified

Oct 7, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Hussam Kujok, MD

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1013081611

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hussam Kujok, MD

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1013081611
  NPD Authorized official

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

{
    "created_epoch": "1628899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1295400869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 HARVARD ST STE 330",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958153317",
            "telephone_number": "916-418-4232",
            "fax_number": "916-418-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 HARVARD ST STE 330",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958153317",
            "telephone_number": "916-418-4232",
            "fax_number": "916-418-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN PRIME HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-14",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "KUJOK",
        "authorized_official_first_name": "HUSSAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-418-4232",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KH Prime Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.