Active NPI
Jerry Masangcay
- Homemaker
- Bloomingdale, IL
National Provider Identifier
1336866169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 3001932
- Practice address
- 121 Fairfield Way Ste 106B
Bloomingdale, IL 60108-1555 - Phone
- (630) 283-0393
- Fax
- (847) 466-7068
- NPI assigned
- Oct 24, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 3001932 | IL | |
| Homemaker | 376J00000X | INH2202079 | IL | |
| Homemaker | 376J00000X | 3001932 | IL | Primary |
Addresses
Primary practice location
121 Fairfield Way Ste 106B
Bloomingdale, IL 60108-1555
Mailing address
4926 Crain St Unit C
Skokie, IL 60077-5444
Phone (847) 466-7069
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3001932 | Other | IL | IDPH LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | admin@infinityhci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3001932 | IL | MD | Home Health Aide |
| INH2202079 | IL | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1336866169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4926 CRAIN ST UNIT C",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600775444",
"telephone_number": "847-466-7069",
"fax_number": "630-283-0343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 FAIRFIELD WAY STE 106B",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601081555",
"telephone_number": "630-283-0393",
"fax_number": "847-466-7068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASANGCAY",
"first_name": "JERRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-24",
"last_updated": "2022-10-24",
"certification_date": "2022-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "IL",
"license": "3001932",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "IL",
"license": "INH2202079",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "IL",
"license": "3001932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDPH LICENSE",
"identifier": "3001932",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "admin@infinityhci.com",
"affiliation": "N",
"address_1": "121 Fairfield Way Ste 106B",
"city": "Bloomingdale",
"state": "IL",
"country_code": "US",
"postal_code": "601081555",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.