Active NPI
Carefocus Corporation
- Home Health Agency
- Saint Paul, MN
National Provider Identifier
1467502070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 876405100
- Legal business name
- CAREFOCUS CORPORATION
- Practice address
- 2429 University Avenue West
St. Paul, MN 55114 - Phone
- (952) 544-6223
- Fax
- (952) 544-6271
- NPI assigned
- Jan 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debra Mead, DIRECTOR OF NURSING
- Title
- Director of Nursing
- Phone
- (651) 925-5598
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 876405100 | MN | Primary |
Addresses
Primary practice location
2429 University Avenue West
St. Paul, MN 55114
Mailing address
2429 University Avenue West
St. Paul, MN 55114
Phone (651) 925-5598
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3D30CA | Other | MN | BLUE CROSS BLUE SHIELD |
| 000821001 | Other | MN | METRO POLITAN HEALTH PLAN |
| 150333 | Other | UCARE | |
| 876405100 | Medicaid | MN | |
| 5900207 | Other | MN | MEDICA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080707000236 | MN | Part A Provider - Home Health Agency | 1254403314 | Practice locations: Saint Paul, MN |
Home health agency certification: CCN 247282
- Legal name
- CAREFOCUS CORPORATION
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 18, 1993
- Last certification
- Feb 26, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Dec 28, 2010 in MN
- Enrollment address
- 2429 University Ave W
Ste 200
Saint Paul, MN 55114-1541
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Carefocus Corporation
- Ownership
- Proprietary
- Certified
- Jun 18, 1993
- Medicare certification status
- Active
- Services
- Nursing, Physical therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0884175 | Carefocus Corporation | Certificate of waiver | Jun 19, 2028 |
National Provider Directory
National Provider DirectoryLocations
2429 University Ave W
Ste 200
Saint Paul, MN 55114
Phone (651) 925-5598
2429 University Ave W
Saint Paul, MN 55114
Phone (612) 703-9413
Ownership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Mary Cathryn Morse | W-2 Managing Employee | Jul 12, 2021 | |
| Adewale Koleosho | 5% Or Greater Direct Ownership Interest | May 9, 1999 | 100% |
| Corporate Director | May 9, 1999 | 100% | |
| W-2 Managing Employee | May 9, 1999 | 100% | |
| Banjelister M Mollel | W-2 Managing Employee | Oct 31, 2016 | |
| Derefaa Henry Cline | W-2 Managing Employee | Nov 1, 2023 | |
| Gegina Beukes | W-2 Managing Employee | Jun 1, 2023 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1273708800000",
"number": "1467502070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2429 UNIVERSITY AVENUE WEST",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55114",
"telephone_number": "651-925-5598",
"fax_number": "651-925-5599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2429 UNIVERSITY AVENUE WEST",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55114",
"telephone_number": "952-544-6223",
"fax_number": "952-544-6271"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAREFOCUS CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-12",
"last_updated": "2010-05-13",
"status": "A",
"authorized_official_last_name": "MEAD",
"authorized_official_first_name": "DEBRA",
"authorized_official_title_or_position": "DIRECTOR OF NURSING",
"authorized_official_telephone_number": "651-925-5598",
"authorized_official_credential": "DIRECTOR OF NURSING"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "MN",
"license": "876405100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3D30CA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRO POLITAN HEALTH PLAN",
"identifier": "000821001",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "150333",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "876405100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "5900207",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.