Indigo Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

INDIGO HOME HEALTH CARE, INC.

Practice address

11755 Victory Blvd Ste 211
North Hollywood, CA 91606-3474

Phone

(818) 208-0480

Fax

(818) 688-3967

NPI assigned

Aug 10, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Hrant Simonyan

Title

Ceo

Phone

(818) 208-0480

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757088

Legal name

INDIGO HOME HEALTH CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 9, 2022

Last certification

Sep 2, 2022

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 27, 2020 in CA

Enrollment address

11755 Victory Blvd
Ste 211
North Hollywood, CA 91606-3474

Listed as

Indigo Home Health Care, Inc.CCN 757088

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Sep 9, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

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

Affiliated clinicians 3

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

• Paula Bailey-Walton, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1174646590

  Home health agency

  Care Compare affiliation
• Yousef Mehrabi, M.D

  • Pediatrics Physician
  • Encino, CA
  • NPI 1083693915

  Home health agency

  Care Compare affiliation
• Bashar Mousa Shahatit, M.D.

  • Family Medicine Physician
  • Apple Valley, CA
  • NPI 1831416742

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1306457817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11755 VICTORY BLVD STE 211",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063474",
            "telephone_number": "818-208-0480",
            "fax_number": "818-688-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11755 VICTORY BLVD STE 211",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063474",
            "telephone_number": "818-208-0480",
            "fax_number": "818-688-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "SIMONYAN",
        "authorized_official_first_name": "HRANT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-208-0480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.