NPIMap

Organization Active NPI

Primary Medical Staffing, Inc.

  • Home Health Agency
  • Miramar, FL
National Provider Identifier
1437397759
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299992253 Issued in FL
Legal business name
PRIMARY MEDICAL STAFFING, INC.
Practice address
3600 Red Rd
Suite 303
Miramar, FL 33025
Phone
(954) 727-1819
Fax
(954) 727-3830
NPI assigned
Jan 23, 2009
Organization subpart
Yes
Parent organization
PRIMARY MEDICAL STAFFING, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Authorized official

Name
Prinston Jean-Glaude
Title
President
Phone
(954) 727-1819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299992253 FL Primary

Addresses

Primary practice location

3600 Red Rd
Suite 303
Miramar, FL 33025

Mailing address

3600 Red Rd Ste 303
Miramar, FL 33025-6014
Phone (954) 727-1819

Other identifiers 2

IdentifierTypeStateIssuer
001030300MedicaidFL
299992253OtherFLHOME HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090225000264 FL Part A Provider - Home Health Agency 5294824561 Practice locations: Miramar, FL

Home health agency certification: CCN 109414

Legal name
PRIMARY MEDICAL STAFFING, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 8, 2009
Last certification
Jul 6, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 11, 2005 in FL
Enrollment address
3600 Red Road
Suite 303
Miramar, FL 33025

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Primary Medical Staffing IncCCN 109414
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Sep 8, 2009
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
Tax ID family
Primary Medical Staffing Inc2 organizations share this tax ID, including this one
Part of
Primary Medical Staffing Inc

Other organizations with this tax ID 1

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

Locations

15025 NW 77th Ave
Ste 126
Miami Lakes, FL 33014
Phone (305) 819-2343

7975 NW 154th St
Ste 370
Miami Lakes, FL 33016
Phone (305) 819-2343

Ownership & related parties

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.

NameRoleSinceShare
Prinston Jean-Glaude Individual 5% Or Greater Direct Ownership Interest Jul 11, 2005 50%
W-2 Managing EmployeeCeo Mar 5, 2007 50%
Edwige Jean-Glaude Individual 5% Or Greater Direct Ownership Interest Jul 11, 2005 50%
W-2 Managing EmployeeVP Mar 5, 2007 50%

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1437397759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 RED RD STE 303",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256014",
            "telephone_number": "954-727-1819",
            "fax_number": "954-580-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 RED RD",
            "address_2": "SUITE 303",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33025",
            "telephone_number": "954-727-1819",
            "fax_number": "954-727-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL STAFFING, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY MEDICAL STAFFING, INC.",
        "enumeration_date": "2009-01-23",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "JEAN-GLAUDE",
        "authorized_official_first_name": "PRINSTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-727-1819"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001030300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH",
            "identifier": "299992253",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.