Organization Active NPI

Carefocus Corporation

  • Home Health Agency
  • Saint Paul, MN
National Provider Identifier
1467502070
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
876405100 Issued in MN
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

Updated by the provider on May 13, 2010

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3D30CAOtherMNBLUE CROSS BLUE SHIELD
000821001OtherMNMETRO POLITAN HEALTH PLAN
150333OtherUCARE
876405100MedicaidMN
5900207OtherMNMEDICA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
Incorporated
Dec 28, 2010 in MN
Enrollment address
2429 University Ave W
Ste 200
Saint Paul, MN 55114-1541
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Carefocus CorporationCCN 247282 · All quality measures
Ownership
Proprietary
Certified
Jun 18, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical 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
24D0884175Carefocus Corporation2429 University Avenue West, Saint Paul, MN 55114Certificate of waiverJun 19, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Mary Cathryn Morse Individual W-2 Managing EmployeeMD; Jul 12, 2021
Adewale Koleosho Individual 5% Or Greater Direct Ownership InterestOwner May 9, 1999 100%
Corporate DirectorPresident May 9, 1999 100%
W-2 Managing EmployeeAdministrator May 9, 1999 100%
Banjelister M Mollel Individual W-2 Managing EmployeeService Cordinator Oct 31, 2016
Derefaa Henry Cline Individual W-2 Managing EmployeeBilling Specialist Nov 1, 2023
Gegina Beukes Individual W-2 Managing EmployeeClinical Manager 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

Verify at the official NPI Registry.