Prime 1 Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRIME 1 HOME HEALTH

Practice address

14531 Hamlin St Ste 106
Van Nuys, CA 91411-4130

Phone

(818) 582-3656

Fax

(818) 528-3658

NPI assigned

Dec 13, 2021

Organization subpart

No

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

Authorized official

Name

Serop Stepanyan

Title

Ceo

Phone

(818) 582-3656

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757435

Legal name

PRIME 1 HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 27, 2023

Last certification

Oct 24, 2023

Organization structure

CorporationProprietary

Enrollment address

14531 Hamlin St
Ste 106
Van Nuys, CA 91411-4140

Listed as

Prime 1 Home HealthCCN 757435 · All quality measures

Ownership

-

Certified

Oct 27, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1326707803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14531 HAMLIN ST STE 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914114130",
            "telephone_number": "818-582-3656",
            "fax_number": "818-528-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14531 HAMLIN ST STE 106",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914114130",
            "telephone_number": "818-582-3656",
            "fax_number": "818-528-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME 1 HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "STEPANYAN",
        "authorized_official_first_name": "SEROP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-582-3656"
    },
    "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 Van Nuys, CA
• Providers in Van Nuys, 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 Dec 13, 2021; 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.