Athome Healthcare Team - East Bay, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ATHOME HEALTHCARE TEAM - EAST BAY, LLC

Practice address

1875 Olympic Blvd Ste 201
Walnut Creek, CA 94596-5026

Phone

(925) 448-2177

NPI assigned

Oct 1, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Jaycee Tan, PTA

Title

Vice President

Phone

(925) 357-0919

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559246

Legal name

ATHOME HEALTHCARE TEAM - EAST BAY LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 21, 2020

Last certification

Oct 21, 2020

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Sep 19, 2018 in CA

Enrollment address

1875 Olympic Blvd
Ste 201
Walnut Creek, CA 94596-5026
HHA Branch

Listed as

Athome Healthcare Team - East Bay, LLCCCN 559246

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Oct 21, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Affiliated clinicians 6

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

• Chika Akera Dow, MD

  • Family Medicine Physician
  • Pleasant Hill, CA
  • NPI 1831319789

  Home health agency

  Care Compare affiliation
• Shruthi R Kooturu, MD

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1740432095

  Home health agency

  Care Compare affiliation
• Sarah Krasny, MD

  • Internal Medicine Physician
  • San Pablo, CA
  • NPI 1891299715

  Home health agency

  Care Compare affiliation
• Claudell Stephens, M.D.

  • Family Medicine Physician
  • Pinole, CA
  • NPI 1437240850

  Home health agency

  Care Compare affiliation
• Edward Robert Teare, APRN-BC

  • Adult Health Nurse Practitioner
  • Oakland, CA
  • NPI 1871832287

  Home health agency

  Care Compare affiliation
• Sri Vardhan Reddy Kooturu, M.D.

  • Internal Medicine Physician
  • Fargo, ND
  • NPI 1760633457

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1477038982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 OLYMPIC BLVD STE 201",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 OLYMPIC BLVD STE 201",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965026",
            "telephone_number": "925-448-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHOME HEALTHCARE TEAM - EAST BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "JAYCEE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "925-357-0919",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Viana Asuncion
• Patricia Anne Santos Atal
• Chelsea Atchley
• Vikram Ati
• Joey Au, R.D.
• Amanda Augello-Chen, OTR/L
• Jake Augustine
• Helen Aumann, PHARM.D.

• All providers in Walnut Creek, CA
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.