Optima Home Health Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

OPTIMA HOME HEALTH SERVICES

Practice address

1935 Chicago Ave Unit C1
Riverside, CA 92507-2368

Phone

(951) 682-7555

Fax

(951) 682-7544

NPI assigned

Nov 8, 2007

Last updated

Apr 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Paul Murillo, RN

Title

Clinical Manager

Phone

(951) 682-7555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396925103. Details of each certification follow.

• CCN 059221 Home health agency · Active · Details

Home health agency certification: CCN 059221

Legal name

OPTIMA HOME HEALTH SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 12, 2009

Last certification

Jan 19, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 4, 2005 in CA

Enrollment address

1935 Chicago Ave
Ste C1
Riverside, CA 92507-2368
HHA Branch

Listed as

Optima Home Health ServicesCCN 059221 · All quality measures

Overall star rating

1 of 5

Ownership

Proprietary

Certified

Feb 12, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 5

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": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1396925103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 CHICAGO AVE UNIT C1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072368",
            "telephone_number": "951-682-7555",
            "fax_number": "951-682-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 CHICAGO AVE UNIT C1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072368",
            "telephone_number": "951-682-7555",
            "fax_number": "951-682-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMA HOME HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "MURILLO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "951-682-7555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396925103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Riverside, CA
• Providers in Riverside, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.