NPIMap

Organization Active NPI

Genesis Home Health Services, Inc.

  • Home Health Agency
  • Ely, NV
National Provider Identifier
1366786162
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
7570HSB-0 Issued in NV
Legal business name
GENESIS HOME HEALTH SERVICES, INC.
Practice address
1500 Avenue F
Suite D
Ely, NV 89301-3506
Phone
(775) 289-2226
NPI assigned
Nov 16, 2012
Last updated
Jan 24, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
GENESIS HOME HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Querubin Iguban
Title
President and Ceo
Phone
(775) 753-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7570HSB-0 NV Primary

Addresses

Primary practice location

1500 Avenue F
Suite D
Ely, NV 89301-3506

Mailing address

2620 Ruby Vista Drive
Elko, NV 89801-3764
Phone (775) 753-7626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121204000010 NV Part A Provider - Home Health Agency 3173580776 Practice locations: Ely, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366786162. Details of each certification follow.

Home health agency certification: CCN 297205

Legal name
GENESIS HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 15, 2013
Last certification
May 22, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 14, 2004 in NV
Enrollment address
705 Avenue K
Ste C
Ely, NV 89301-2701
HHA Branch

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Genesis Home Health Services, IncCCN 297205 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jul 15, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology

National Provider Directory

National Provider Directory
Tax ID family
Genesis Home Health Services Inc3 organizations share this tax ID, including this one
Part of
Genesis Home Health Services Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2620 Ruby Vista Dr
Elko, NV 89801
Phone (775) 753-7626

1500 Avenue F
Ste D
Ely, NV 89301
Phone (775) 289-2002

705 Avenue K
Ste C
Ely, NV 89301
Phone (775) 289-2226

400 W 4th St
Winnemucca, NV 89445
Phone (775) 625-1002

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Querubin Iguban Individual 5% Or Greater Direct Ownership Interest Jun 14, 2004 50%
Corporate OfficerPresident, Chairman and Ceo Jun 14, 2004 50%
W-2 Managing EmployeeCeo Jun 14, 2004 50%
Operational/Managerial ControlCeo Jun 14, 2004 50%
Celestine Q Hernandez Individual 5% Or Greater Direct Ownership Interest Jun 14, 2004 50%
Corporate OfficerV.P, Director & Secretary Jun 14, 2004 50%
Corporate DirectorVice-President & Secretary Jun 14, 2004 50%
W-2 Managing EmployeeMedical Director Jun 14, 2004 50%
Operational/Managerial ControlMedical Director Jun 14, 2004 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Celestine Q Hernandez, MD
    • Pediatrics Physician
    • Elko, NV
    • NPI 1689739161

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1366786162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 RUBY VISTA DRIVE",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013764",
            "telephone_number": "775-753-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 AVENUE F",
            "address_2": "SUITE D",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893013506",
            "telephone_number": "775-289-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS HOME HEALTH SERVICES, INC.",
        "enumeration_date": "2012-11-16",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "IGUBAN",
        "authorized_official_first_name": "QUERUBIN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "775-753-7626"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "7570HSB-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ely, NV

Sources for this page

Verify at the official NPI Registry.