Express Homeservice Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXPRESS HOMESERVICE INC

Practice address

13515 Victory Blvd Suite 207
Van Nuys, CA 91401

Phone

(818) 452-5484

NPI assigned

Jul 12, 2019

Last updated

Jul 12, 2019By 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

Suzy Jabaguryan

Title

Ceo

Phone

(818) 452-5484

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 1467004101. Details of each certification follow.

• CCN 559334 Home health agency · Active · Details

Home health agency certification: CCN 559334

Legal name

EXPRESS HOMESERVICE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 18, 2020

Last certification

Sep 18, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 8, 2019 in CA

Enrollment address

7220 Woodman Ave
Ste 205
Van Nuys, CA 91405-2668

Listed as

Express Homeservice IncCCN 559334 · All quality measures

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Sep 18, 2020

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 1

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

Affiliated clinicians 1

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

• Maria Cristina Ortiz, M.D.

  • Family Medicine Physician
  • San Fernando, CA
  • NPI 1962494641

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1467004101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 VICTORY BLVD SUITE 207",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-452-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 VICTORY BLVD SUITE 207",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91401",
            "telephone_number": "818-452-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS HOMESERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "JABAGURYAN",
        "authorized_official_first_name": "SUZY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-452-5484"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Expert Compounding Pharmacy Inc
• Expert Medical Supplies (Lacienega Pharmacy)
• Express Home Care
• Exrx Inc (Exigency Compounding Pharmacy)
• F.Manavi Dental Corporation (West Coast Dental Group of Van Nuys)
• Alsina Faal
• Marisol Fackler
• Behzad Fadaei, D.D.S

• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, 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 Jul 12, 2019; 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.