NPIMap

Organization Active NPI

Vital Home Health Care, LLC

  • Home Health Agency
  • Hayward, CA
National Provider Identifier
1376848408
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
VITAL HOME HEALTH CARE, LLC
Practice address
1090 La Playa Dr Ste 288
Hayward, CA 94545-2142
Phone
(510) 575-9898
NPI assigned
Jan 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Grace Xin Xin Shao
Title
Coo
Phone
(415) 627-7833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1090 La Playa Dr Ste 288
Hayward, CA 94545-2142

Mailing address

1090 La Playa Dr Ste 288
Hayward, CA 94545-2142
Phone (510) 575-9898

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120209000653 CA Part A Provider - Home Health Agency 0648437244 Practice locations: Hayward, CA

Home health agency certification: CCN 059462

Legal name
VITAL HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 8, 2013
Last certification
Jan 11, 2019
Ownership / control type
Proprietary
Organization structure
OtherProprietary
Incorporated
Dec 27, 2010
Enrollment address
1090 La Playa Dr
Ste 288
Hayward, CA 94545-2142

Care Compare: Home health agency

Medicare Care Compare
Listed as
Vital Home Health CareCCN 059462
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 8, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

800 Airport Blvd
Ste 412
Burlingame, CA 94010
Phone (650) 779-4700

533 Airport Blvd
Ste 521
Burlingame, CA 94010
Phone (650) 779-4700

1090 La Playa Dr
Ste 288
Hayward, CA 94545
Phone (510) 575-9898

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
Xiaofeng Shameson Individual 5% Or Greater Direct Ownership InterestOwner Jul 20, 2018 85%
Corporate OfficerCeo/President Jul 20, 2018 100%
Corporate DirectorManaging Member Jul 20, 2018 100%
Operational/Managerial ControlCeo Jul 20, 2018 100%
Xin Xin Shao Individual 5% Or Greater Direct Ownership InterestOwner Jul 20, 2018 15%
Corporate OfficerChief Operating Officer Jul 20, 2018 100%
Corporate DirectorBoard Member Jul 20, 2018 100%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1376848408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 LA PLAYA DR STE 288",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452142",
            "telephone_number": "510-575-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 LA PLAYA DR STE 288",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452142",
            "telephone_number": "510-575-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-21",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "SHAO",
        "authorized_official_first_name": "GRACE XIN XIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "415-627-7833"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.