Excel Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXCEL HOME HEALTH

Practice address

5575 Lake Park Way
Suite 220
La Mesa, CA 91942

Phone

(619) 460-6622

Fax

(619) 460-6873

NPI assigned

Sep 28, 2006

Last updated

Aug 22, 2020By 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. Sri Gopal

Title

Administrator

Phone

(619) 460-6622

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336230689. Details of each certification follow.

• CCN 557494 Home health agency · Active · Details

Home health agency certification: CCN 557494

Legal name

EXCEL HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 13, 1995

Last certification

Jul 11, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 3, 1994 in CA

Enrollment address

5575 Lake Park Way
Ste 220
La Mesa, CA 91942-1684

Listed as

Excel Home HealthCCN 557494 · All quality measures

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Jan 13, 1995

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

Locations

All disclosed owners & managing parties 4

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336230689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 LAKE PARK WAY",
            "address_2": "SUITE 220",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-460-6622",
            "fax_number": "619-460-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 LAKE PARK WAY",
            "address_2": "SUITE 220",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-460-6622",
            "fax_number": "619-460-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOPAL",
        "authorized_official_first_name": "SRI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-460-6622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA57494F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in La Mesa, CA
• Providers in La Mesa, 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 22, 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.