Healthy Palace Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

HEALTHY PALACE HOME HEALTH CARE, INC.

Practice address

7335 Van Nuys Blvd Ste 116
Van Nuys, CA 91405-1951

Phone

(747) 300-0805

Fax

(747) 300-0806

NPI assigned

Apr 19, 2021

Last updated

Apr 19, 2021By 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

Edvard Petrosyan

Title

Ceo

Phone

(747) 300-0805

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 1487235792. Details of each certification follow.

• CCN 757460 Home health agency · Active · Details

Home health agency certification: CCN 757460

Legal name

HEALTHY PALACE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 15, 2023

Last certification

Nov 15, 2023

Organization structure

CorporationProprietary

Enrollment address

1141 N Brand Blvd
Ste 206
Glendale, CA 91202-2511

Listed as

Healthy Palace Home Health Care, IncCCN 757460 · All quality measures

Overall star rating

3 of 5

Ownership

-

Certified

Nov 15, 2023

Medicare certification status

ActiveFrom the Provider of Services file

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.

Affiliated clinicians 7

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

• John Andrew Fagan, MD

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1306904628

  Home health agency

  Care Compare affiliation
• Philip E Hill, M.D.

  • Orthopaedic Surgery Physician
  • Long Beach, CA
  • NPI 1770583429

  Home health agency

  Care Compare affiliation
• Isaac M Minehart, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Arcadia, CA
  • NPI 1639167091

  Home health agency

  Care Compare affiliation
• Bernadette Pendergraph, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Torrance, CA
  • NPI 1184634016

  Home health agency

  Care Compare affiliation
• Cong Thanh Phan, M.D.

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1386778033

  Home health agency

  Care Compare affiliation
• Sanjeev Puri, D.O

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1730420399

  Home health agency

  Care Compare affiliation
• Heather Bennett Schickedanz, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1679875223

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1487235792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7335 VAN NUYS BLVD STE 116",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051951",
            "telephone_number": "747-300-0805",
            "fax_number": "747-300-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7335 VAN NUYS BLVD STE 116",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051951",
            "telephone_number": "747-300-0805",
            "fax_number": "747-300-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY PALACE HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "PETROSYAN",
        "authorized_official_first_name": "EDVARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-300-0805"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, 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 Apr 19, 2021; 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.