Mary T Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

331577 Issued in MN

Legal business name

MARY T HOME HEALTH INC

Practice address

11777 Xeon Blvd NW
Coon Rapids, MN 55448-2060

Phone

(763) 862-5436

Fax

(763) 754-0332

NPI assigned

Feb 13, 2008

Organization subpart

Yes

Parent organization

MARY T ASSOCIATES INCAs reported in NPPES

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

Authorized official

Name

Deborah Ann Weiss

Title

Director

Phone

(763) 862-5426

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Home health agency certification: CCN 247292

Legal name

MARY T HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 14, 1993

Last certification

Mar 14, 2019

Ownership / control type

Non-Profit

Organization structure

CorporationProprietary

Enrollment address

11777 Xeon Blvd NW
Coon Rapids, MN 55448-2060

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mary T Home Health Inc

  • Community Based Hospice Care Agency
  • Coon Rapids, MN
  • NPI 1346487238

  4880618131

  Same PAC ID

Listed as

Mary T Home HealthCCN 247292

Overall star rating

3.5 of 5

Ownership

Non-Profit

Certified

Oct 14, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Part of

Mary T Associates Inc

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Mary T Outpatient

  • Physical Therapist
  • Coon Rapids, MN
  • NPI 1396475927

  Member Of

  NPD member

Locations

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.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Mary T Home Health Inc

  • Community Based Hospice Care Agency
  • Coon Rapids, MN
  • NPI 1346487238

  Mary T Associates Inc

  CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Mary T Associates Inc

  • Home Health Agency
  • Coon Rapids, MN
  • NPI 1770643694
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carrie Peterson, OTR

  • Occupational Therapist
  • Coon Rapids, MN
  • NPI 1134232952
  NPD (past)

Affiliated clinicians 1

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

• Thomas Mwambi Ondara

  • Family Nurse Practitioner
  • Minneapolis, MN
  • NPI 1891567780

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1497923346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 XEON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482061",
            "telephone_number": "763-862-5436",
            "fax_number": "763-754-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11777 XEON BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482060",
            "telephone_number": "763-862-5436",
            "fax_number": "763-754-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38873 14th Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "North Branch",
            "state": "MN",
            "postal_code": "550565727",
            "country_code": "US",
            "telephone_number": "651-237-1184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARY T HOME HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY T ASSOCIATES INC",
        "enumeration_date": "2008-02-13",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "763-862-5426"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "331577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1880433",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia J Martinson, CRNA
• Faith Marty
• Marissa Emily Marx, LPCC
• Mary T Associates Inc
• Mary T Home Health Inc
• Mary T Hospice
• Mary T Outpatient
• Beth Tuttle Maschoff, RDN, LD
• Jael Masi
• Rachael Mason

• Home Health Agency in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.