Omega Home Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

OMEGA HOME HEALTHCARE LLC

Practice address

1432 Old West Main St
Red Wing, MN 55066-2161

Phone

(888) 995-4742

Fax

(507) 252-1985

NPI assigned

Jul 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Aderonke Olanrewaju Mordi

Title

President and Ceo

Phone

(507) 951-4344

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 247011

Legal name

OMEGA HOME HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 1, 1966

Last certification

Feb 7, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 31, 2019 in MN

Enrollment address

1432 Old West Main St
Red Wing, MN 55066-2161

Other NPIs with the same Medicare PAC ID 1

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

• Omega Home Healthcare LLC

  • Home Health Agency
  • Eagan, MN
  • NPI 1710513437

  6608104799

  Same PAC ID

Listed as

Omega Home Healthcare LLCCCN 247011 · All quality measures

Ownership

Proprietary

Certified

Jul 1, 1966

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Omega Home Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Omega Home Healthcare LLC

  • Home Health Agency
  • Eagan, MN
  • NPI 1710513437
  NPD tax ID

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.

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Accra Home Health Inc

  • Home Health Agency
  • Hopkins, MN
  • NPI 1801125554

  Acquired from, 2019-09-30

  CMS change of ownership

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1417509472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 FAIRWAY PL NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559015039",
            "telephone_number": "888-995-4742",
            "fax_number": "507-252-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 OLD WEST MAIN ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662161",
            "telephone_number": "888-995-4742",
            "fax_number": "507-252-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "MORDI",
        "authorized_official_first_name": "ADERONKE",
        "authorized_official_middle_name": "OLANREWAJU",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "507-951-4344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Neil Olson, MSW
• Jodilynn F Olson, PHD-LP
• Margaret Sarah Olson
• Nancy Ronae Olson, RN DIETITION
• Steven Paul Olson, RPH
• Wren Jean Ornquist
• Gretchen Elizabeth Orso
• Molly Lynn Kathleen Orso
• Abigail Anne Oswald
• Oluwafunmilayo Omotoyosi Oyatogun, MD

• Home Health Agency in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.