Organization Active NPI

Premier Home Care, Inc.

  • Home Health Agency
  • Huntingdon Valley, PA
National Provider Identifier
1417906264
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
02620501 Issued in PA
Legal business name
PREMIER HOME CARE, INC.
Practice address
1800 Byberry Rd Ste 1201
Huntingdon Valley, PA 19006-3524
Phone
(215) 969-2225
Fax
(215) 969-2276
NPI assigned
May 9, 2006
Last updated
Nov 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Ms. Irene Michelle Brotsky
Title
President
Phone
(215) 969-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 02620501 PA Primary

Addresses

Primary practice location

1800 Byberry Rd Ste 1201
Huntingdon Valley, PA 19006-3524

Mailing address

1800 Byberry Rd Ste 1201
Huntingdon Valley, PA 19006-3524
Phone (215) 969-2225

Other identifiers 1

IdentifierTypeStateIssuer
1015021530001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051006000300 PA Part A Provider - Home Health Agency 7315962677 Practice locations: Huntingdon Valley, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417906264. Details of each certification follow.

Home health agency certification: CCN 398040

Legal name
PREMIER HOME CARE, INC.
Doing business as
PREMIER HOME CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 8, 2005
Last certification
Sep 18, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 12, 2000 in PA
Enrollment address
1800 Byberry Rd
Ste 1201
Huntingdon Valley, PA 19006-3524

Care Compare: Home health agency

Medicare Care Compare
Listed as
Premier Home Care IncCCN 398040 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Dec 8, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1044547Premier Home Care Inc1800 Byberry Rd, Suite# 1201, Huntingdon Valley, PA 19006Certificate of waiverAug 22, 2027

National Provider Directory

National Provider Directory

Locations

1800 Byberry Rd
Ste 1201
Huntingdon Valley, PA 19006
Phone (215) 969-2225

9880 Bustleton Ave
Ste 203
Philadelphia, PA 19115
Phone (215) 969-2225

9880 Bustleton Ave
Ste 309
Philadelphia, PA 19115
Phone (215) 676-6060

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Irene Brotsky Individual 5% Or Greater Direct Ownership Interest Dec 29, 2016 100%
Corporate OfficerPresident/Administrator Jun 14, 2005
Corporate DirectorPresident/Administrator Jun 14, 2005
W-2 Managing EmployeeAdministrator/Director of Nursin Jun 14, 2005
Operational/Managerial ControlAdministrator/Director of Nursin Jun 14, 2005

Practitioners & affiliated clinicians

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1417906264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BYBERRY RD STE 1201",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190063524",
            "telephone_number": "215-969-2225",
            "fax_number": "215-969-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BYBERRY RD STE 1201",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190063524",
            "telephone_number": "215-969-2225",
            "fax_number": "215-969-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "BROTSKY",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-969-2225",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "02620501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015021530001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon Valley, PA

Sources for this page

Verify at the official NPI Registry.