Protem Homecare

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROTEM HOMECARE

Doing business as

LightHouse Home Care

Practice address

5455 Broadview Rd
Parma, OH 44134-7812

Phone

(216) 377-1927

Fax

(216) 377-1974

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Ed Allen Newton

Title

Member

Phone

(216) 644-6084

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LightHouse Home Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477637163. Details of each certification follow.

• CCN 368150 Home health agency · Active · Details

Home health agency certification: CCN 368150

Legal name

PROTEM HOMECARE

Doing business as

PROTEM HOMECARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 22, 2006

Last certification

Nov 16, 2017

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

in OH

Enrollment address

3535 Lee Rd
Shaker Heights, OH 44120-5122

Listed as

Lighthouse Home CareCCN 368150 · All quality measures

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Sep 22, 2006

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 2

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Ada Nworie, RN, PHMNP

  • Psychiatry Physician
  • Shaker Heights, OH
  • NPI 1760901524

  5% Or Greater Direct Ownership Interest, Corporate Director, General Partnership Interest, W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1477637163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441347812",
            "telephone_number": "216-377-1927",
            "fax_number": "216-377-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441347812",
            "telephone_number": "216-377-1927",
            "fax_number": "216-377-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTEM HOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "ED",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "216-644-6084"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2697890",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LightHouse Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Progressive Parma Care Center LLC (Parma - Laboratory)
• Progressive Parma Care Center LLC (Parma Care Center)
• Karen Ann Prokop
• Promed Healthcare LLC
• Promed Healthcare LLC
• Lisa M Pugely, R.N.
• Judith Anne Pullar
• Nicholas P Pullar, CT
• Erica Pullins, MS, CCC-SLP
• Basanta Pun Magar, MBBS, MD

• Home Health Agency in Parma, OH
• Providers in Parma, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.