Medaid Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEDAID HOME HEALTH

Practice address

639 S Glenwood PL Ste 107a
Burbank, CA 91506-2819

Phone

(818) 974-8998

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Grigor Pogosyan

Title

President

Phone

(818) 974-8998

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757589

Legal name

MEDAID HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 20, 2023

Last certification

Aug 11, 2023

Organization structure

CorporationProprietary

Enrollment address

639 S Glenwood PL
Ste 107a
Burbank, CA 91506-2819

Listed as

Medaid Home HealthCCN 757589

Overall star rating

1.5 of 5

Ownership

-

Certified

Oct 20, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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 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": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1356924013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 S GLENWOOD PL STE 107A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 S GLENWOOD PL STE 107A",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062819",
            "telephone_number": "818-974-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDAID HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "POGOSYAN",
        "authorized_official_first_name": "GRIGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-974-8998"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.