Senior Residence Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SENIOR RESIDENCE SERVICES LLC

Doing business as

Nomoli Healthcare

Practice address

5506 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-7673

Phone

(702) 369-5533

Fax

(702) 369-2018

NPI assigned

Mar 4, 2022

Organization subpart

No

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

Authorized official

Name

Nicholas Gambino

Title

Administrator

Phone

(702) 369-5533

Specialties & licenses 1

Addresses

Other names 1

• Nomoli Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Home health agency certification: CCN 297339

Legal name

SENIOR RESIDENCE SERVICES LLC

Doing business as

NOMOLI HEALTHCARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 25, 2023

Last certification

Oct 5, 2023

Organization structure

LLCProprietary

Incorporated

Dec 22, 2020 in NV

Enrollment address

5506 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148-7673

Listed as

Nomoli HealthcareCCN 297339

Overall star rating

2.5 of 5

Ownership

-

Certified

Oct 25, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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 2

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

• Donielle Freedman, M.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1346315900

  Home health agency

  Care Compare affiliation
• Russell T. Nevins, MD

  • Orthopaedic Surgery Physician
  • Las Vegas, NV
  • NPI 1306845649

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1497402978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487673",
            "telephone_number": "702-369-5533",
            "fax_number": "702-369-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5506 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487673",
            "telephone_number": "702-369-5533",
            "fax_number": "702-369-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR RESIDENCE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "GAMBINO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-369-5533"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nomoli Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.