Billet Home Health Inc Mesa
Organization Active NPI Home Health Agency · Mesa, AZ
NPI 1396497889 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1396497889
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- BILLET HOME HEALTH INC MESA
- Practice address
- 931 E Southern Ave Ste 207
Mesa, AZ 85204-5043 - Phone
- (833) 224-5538
- NPI assigned
- Jan 25, 2022
- Organization subpart
- No
Authorized official
- Name
- Vahan Oganesyan
- Title
- Coo
- Phone
- (833) 224-5538
Facilities with the same owner 3
Affiliated clinicians 14
-
Sara Kay Bennett, DNP, RNP, FNP
-
Douglas J Campbell, M.D.
-
Tanner Bo Carlson, PA-C
-
Michelle Anne Craft, APRN-RNP, FNP-BC
-
Fernando Cruzado, MD
-
Horst Filtzer, M.D.
-
Margo Ruth Flores, NP-C
-
Blaine S. Jensen, PA-C
-
Brent J Layton, MD
-
Holly Elizabeth Rooney, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Billet Home Health Inc - Mesa
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- -
- Certified
- Apr 2, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2268759 | Billet Home Health Inc-Mesa | Certificate of waiver | Sep 15, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Home health agency certification: CCN 037828
- Legal name
- BILLET HOME HEALTH INC MESA
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 2, 2023
- Last certification
- Mar 23, 2023
- Organization structure
- Corporation · Proprietary
- Incorporated
- Dec 13, 2021 in AZ
- Enrollment address
- 931 E Southern Ave
Ste 207
Mesa, AZ 85204-5043
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Edgar Garcia Vazquez |
5% Or Greater Direct Ownership Interest |
Dec 13, 2021 | 51% |
| Corporate Officer |
Dec 13, 2021 | 51% | |
| W-2 Managing Employee |
Dec 13, 2021 | 51% | |
| BHCM Inc |
5% Or Greater Direct Ownership Interest | Dec 13, 2021 | 49% |
| Armen Ghadimian |
5% Or Greater Indirect Ownership Interest | Dec 13, 2021 | 24.5% |
| Corporate Officer |
Dec 13, 2021 | 24.5% | |
| W-2 Managing Employee |
Dec 13, 2021 | 24.5% | |
| Vahan Oganesyan |
5% Or Greater Indirect Ownership Interest | Dec 13, 2021 | 24.5% |
| Corporate Officer |
Dec 13, 2021 | 24.5% | |
| W-2 Managing Employee |
Dec 13, 2021 | 24.5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220608002778 | AZ | Part a Provider - Home Health Agency | 8325426018 | Practice locations: Mesa, AZ |
National Provider Directory
Locations
931 E Southern Ave
Ste 207
Mesa, AZ 85204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
931 E Southern Ave Ste 207
Mesa, AZ 85204-5043
Mailing address
6710 N 47TH Ave
Glendale, AZ 85301-4121
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.