Active NPI
Flor de la Fe Home Health LLC
- Home Health Agency
- Brownsville, TX
National Provider Identifier
1487255394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- FLOR DE LA FE HOME HEALTH LLC
- Practice address
- 4804 Beaver Pond Dr
Brownsville, TX 78520-9225 - Phone
- (956) 466-8862
- NPI assigned
- Nov 6, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jose A Medina
- Title
- Owner
- Phone
- (956) 466-8862
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
4804 Beaver Pond Dr
Brownsville, TX 78520-9225
Mailing address
4804 Beaver Pond Dr
Brownsville, TX 78520-9225
Phone (956) 466-8862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210323000182 | TX | Part A Provider - Home Health Agency | 8729495593 | Practice locations: Brownsville, TX |
Home health agency certification: CCN 748010
- Legal name
- FLOR DE LA FE HOME HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 17, 2021
- Last certification
- May 17, 2021
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Sep 14, 2020 in TX
- Enrollment address
- 4804 Beaver Pond Dr
Brownsville, TX 78520-9225
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Flor de la Fe Home Health LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- May 17, 2021
- Medicare certification status
- Active
- Services
- Nursing, Physical therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2202993 | Flor de la Fe Home Health LLC | Certificate of waiver | Dec 1, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Jose Angel Medina | 5% Or Greater Direct Ownership Interest | Sep 14, 2020 | 100% |
| Corporate Director | Sep 14, 2020 | ||
| Josephina Medina | Corporate Director | Sep 14, 2020 | |
| W-2 Managing Employee | Sep 15, 2020 | ||
| Corina Medina | W-2 Managing Employee | Sep 15, 2020 | |
| Noelia Maldonado | W-2 Managing Employee | Sep 15, 2020 |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physical Medicine & Rehabilitation Physician
- Brownsville, TX
- NPI 1326034059
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604620800000",
"number": "1487255394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4804 BEAVER POND DR",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785209225",
"telephone_number": "956-466-8862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4804 BEAVER POND DR",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785209225",
"telephone_number": "956-466-8862"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLOR DE LA FE HOME HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A",
"authorized_official_last_name": "MEDINA",
"authorized_official_first_name": "JOSE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "956-466-8862"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.