Samaritan Home Health Inc
Organization Active NPI Home Health Agency · Watertown, NY
NPI 1487057576 · NPPES record last updated Dec 15, 2021
Key facts
- NPI
- 1487057576
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- SAMARITAN HOME HEALTH INC
- Practice address
- 104 Paddock St
Watertown, NY 13601-0000 - Phone
- (315) 782-0415
- Fax
- (315) 786-0417
- NPI assigned
- Oct 2, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- SAMARITAN HOME HEALTH INC
Authorized official
- Name
- Mr. Thomas Carman
- Title
- President
- Phone
- (315) 785-4121
Change of ownership 1
Practitioners 18
-
Julia Marie Bashaw, PA-C
-
Matthew Joseph Ben, M.D.
-
Desiree Starr Fuller, FNP
-
Anna Elizabeth Garrabrant, MSN, APRN, FNP-BC
-
Nicolas Jaeggi, MD
-
Maksim Liaukovich, M.D.
-
Robyn Michele McGowan, PMHNP
-
Frank Rhode, MD
-
Marisa Ann Yates, PA-C
-
Sheikh Latif, M.D.
-
Gayathri Mahendiran, M.D.
-
Elie Nehme, MD
-
Tariq Siddiqui, MD
Affiliated clinicians 29
-
Biren V Chokshi, M.D.
-
Jon A Emerton, M.D.
-
Kenneth J Fish Sr., D.O.
-
Aaron Dale Huizenga, D.O.
-
Marcia Mauger, MD
-
Scott H Mitchell, M.D.
-
Molly Pleskach, FNP
-
Colin Michael Ross, PHYSICIAN ASSISTANT
-
Bonnie L Servage, ANP
-
Scott D Stern, MD
-
Maurice Tom Pack, M.D.
-
Lisa J Trickey, PA C
-
Ryan E Tyler, M.D.
-
Joseph Wetterhahn, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Samaritan Home Health, Inc
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Non-Profit
- Certified
- Apr 15, 1988
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Physical therapy, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Home health agency certification: CCN 337254
- Legal name
- SAMARITAN HOME HEALTH INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 15, 1988
- Last certification
- Mar 25, 2021
- Ownership / control type
- Non-Profit
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 7, 2012 in NY
- Enrollment address
- 104 Paddock St
Watertown, NY 13601-3962
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Chris Hochgraf |
W-2 Managing Employee |
Jan 1, 2022 | |
| Operational/Managerial Control |
Jan 1, 2022 | ||
| Maxine a Briggs |
Corporate Director |
Jan 1, 2022 | |
| W-2 Managing Employee |
Jan 1, 2022 | ||
| Operational/Managerial Control |
Jan 1, 2022 | ||
| Thomas H Carman |
Corporate Director |
Aug 7, 2012 | |
| W-2 Managing Employee |
Aug 7, 2012 | ||
| Operational/Managerial Control |
Aug 7, 2012 | ||
| Melanie Parker-Guertsen |
Corporate Director |
Jan 1, 2022 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jan 1, 2016 | Change of Ownership |
Genesis Healthcare of New York |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151007002165 | NY | Part a Provider - Home Health Agency | 0244548477 | Practice locations: Watertown, NY |
National Provider Directory
- Part of
- Samaritan Home Health Inc
Locations
104 Paddock St
Watertown, NY 13601
Phone (315) 786-7501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
104 Paddock St
Watertown, NY 13601-0000
Mailing address
104 Paddock St
Watertown, NY 13601-0000
Phone (315) 782-0415
Other providers in Watertown, NY
- Carlice Cecil Ruttan II
- Corey Douglas Ryan
- S.T.a.T Communications, Inc
- Evette Sadler
- Samantha M Salisbury
- Samaritan Keep Nursing Home Inc
- Samaritan Medical Center
- Samaritan Medical Center
- Samaritan Medical Center
- Samaritan Medical Center
All providers in Watertown, NY · Home Health Agency in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.