Organization Active NPI

Aging Paradise Inc.

Doing business as Aging Paradise

  • Home Health Agency
  • Oakland Park, FL
National Provider Identifier
1427224666
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
AGING PARADISE INC.
Doing business as
Aging Paradise
Practice address
1620 West Oakland Park Blvd Ste 203
Oakland Park, FL 33311
Phone
(954) 431-8808
Fax
(954) 431-8898
NPI assigned
May 7, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Solomon Mathew Jr.
Title
President
Phone
(954) 940-8555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X FL Primary

Addresses

Primary practice location

1620 West Oakland Park Blvd Ste 203
Oakland Park, FL 33311

Mailing address

1620 West Oakland Park Blvd. Ste 203
Oakland Par, FL 33311
Phone (954) 431-8808

Other names 1

  • Aging Paradise Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090408000204 FL Part A Provider - Home Health Agency 0840347803 Practice locations: Oakland Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427224666. Details of each certification follow.

Home health agency certification: CCN 109502

Legal name
AGING PARADISE, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 16, 2010
Last certification
Sep 29, 2014
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
1620 W. Oakland Park Blvd.
Ste. 203
Oakland Park, FL 33311-1506
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Aging Paradise IncCCN 109502 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Feb 16, 2010
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

1620 W Oakland Park Blvd
Ste 203
Oakland Park, FL 33311
Phone (954) 431-8808

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Cyril George Individual 5% Or Greater Direct Ownership Interest Jun 16, 2021 50%
Shirly Philip Individual W-2 Managing EmployeeDirector of Nursing Jun 16, 2021 100%
Roni Quintana Individual Corporate Director Apr 1, 2021 100%
Solomon Mathew Living Trust Organization, Oakland Park, FL 5% Or Greater Direct Ownership Interest Apr 1, 2021 50%

Practitioners & affiliated clinicians

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427224666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 WEST OAKLAND PARK BLVD. STE 203",
            "city": "OAKLAND PAR",
            "state": "FL",
            "postal_code": "33311",
            "telephone_number": "954-431-8808",
            "fax_number": "954-431-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 WEST OAKLAND PARK BLVD STE 203",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "33311",
            "telephone_number": "954-431-8808",
            "fax_number": "954-431-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGING PARADISE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-940-8555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aging Paradise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.