Blue Iris Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLUE IRIS HOME HEALTH, INC.

Practice address

3820 Del Amo Blvd Ste 228
Torrance, CA 90503-2154

Phone

(323) 774-6393

Fax

(323) 521-2337

NPI assigned

Jul 17, 2018

Last updated

Jul 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Kokaya

Title

Ceo

Phone

(323) 774-6393

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487130043. Details of each certification follow.

• CCN 559594 Home health agency · Active · Details

Home health agency certification: CCN 559594

Legal name

BLUE IRIS HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 14, 2021

Last certification

Jun 14, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 11, 2018 in CA

Enrollment address

3820 Del Amo Blvd
Ste 228
Torrance, CA 90503-2154
HHA Branch

Listed as

Blue Iris Home Health, IncCCN 559594 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Jun 14, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Locations

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1487130043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 DEL AMO BLVD STE 228",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032154",
            "telephone_number": "323-774-6393",
            "fax_number": "323-521-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 DEL AMO BLVD STE 228",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032154",
            "telephone_number": "323-774-6393",
            "fax_number": "323-521-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE IRIS HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "KOKAYA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-774-6393"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Torrance, CA
• Providers in Torrance, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.