Good Shepherd Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GOOD SHEPHERD HOME HEALTH LLC

Practice address

18623 Ventura Blvd. Suite 205
Tarzana, CA 91356-6802

Phone

(818) 578-6095

Fax

(818) 578-6010

NPI assigned

Jul 22, 2014

Organization subpart

No

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

Authorized official

Name

Carlota Robles Espino

Title

Ceo/Administrator

Phone

(213) 400-5750

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 1508273558. Details of each certification follow.

• CCN 059701 Home health agency · Active · Details

Home health agency certification: CCN 059701

Legal name

GOOD SHEPHERD HOME HEALTH LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 7, 2016

Last certification

Jan 7, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

18623 Ventura Blvd
Ste 205
Tarzana, CA 91356-4140
HHA Branch

Listed as

Good Shepherd Home Health, LLCCCN 059701 · All quality measures

Overall star rating

1.5 of 5

Ownership

Proprietary

Certified

Jan 7, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

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

CLIA laboratory certificates

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.

Affiliated clinicians 4

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

• Gary Austin Grimes, MD

  • Family Medicine Physician
  • Palmdale, CA
  • NPI 1922172089

  Home health agency

  Care Compare affiliation
• Ahmad Jabaiah, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1396122081

  Home health agency

  Care Compare affiliation
• Jessica Ann Wang

  • Family Medicine Physician
  • Encino, CA
  • NPI 1831644004

  Home health agency

  Care Compare affiliation
• Sam Suman Nuthalapaty, M.D

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1972758787

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1508273558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18623 VENTURA BLVD. SUITE 205",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566802",
            "telephone_number": "818-578-6095",
            "fax_number": "818-578-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18623 VENTURA BLVD. SUITE 205",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913566802",
            "telephone_number": "818-578-6095",
            "fax_number": "818-578-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "ESPINO",
        "authorized_official_first_name": "CARLOTA",
        "authorized_official_middle_name": "ROBLES",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "213-400-5750"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Narda Iris Gonzalez
• Rafael Gonzalez
• Stephen Gonzalez
• Good Heart Recovery, LLC.
• Good Life Resources, Inc.
• David L Good, D.D.S.
• Rachel Goodman, M.S., R.D.
• Arun Gopal, M.D.
• Isaac Gorbaty, M.D.
• Melissa Gordon, MS

• Home Health Agency in Tarzana, CA
• Providers in Tarzana, 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 Oct 17, 2019; 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.