NPIMap

Organization Active NPI

Staff Assistance, Inc.

Doing business as Assisted Healthcare Services

  • Home Health Agency
  • Thousand Oaks, CA
National Provider Identifier
1508819020
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
9800879 Issued in CA
Legal business name
STAFF ASSISTANCE, INC.
Doing business as
Assisted Healthcare Services
Practice address
72 Moody Court
Suite 203
Thousand Oaks, CA 91360-6067
Phone
(805) 379-3031
Fax
(805) 371-9880
NPI assigned
May 18, 2006
Last updated
Jan 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
STAFF ASSISTANCE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Authorized official

Name
Mr. Gerd F Kerswill, CPA
Title
Cfo
Phone
(805) 371-9988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 9800879 CA Primary

Addresses

Primary practice location

72 Moody Court
Suite 203
Thousand Oaks, CA 91360-6067

Mailing address

72 Moody Court Suite 100
Thousand Oaks, CA 91360-6067
Phone (805) 371-9988

Other identifiers 1

IdentifierTypeStateIssuer
HHA57514FMedicaidCA

Other names 1

  • ASSISTED HEALTHCARE SERVICES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080509000289 CA Part A Provider - Home Health Agency 8820905706 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thousand Oaks, CA; Mission Hills, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508819020. Details of each certification follow.

Home health agency certification: CCN 557514

Legal name
STAFF ASSISTANCE, INC.
Doing business as
ASSISTED HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 17, 1995
Last certification
Jul 11, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 14, 1992 in CA
Enrollment address
10550 Sepulveda Blvd
Ste 118
Mission Hills, CA 91345-1961
HHA Branch

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Assisted Healthcare ServicesCCN 557514 · All quality measures
Ownership
Proprietary
Certified
Mar 17, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Staff Assistance Inc6 organizations share this tax ID, including this one
Part of
Staff Assistance Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

468 Pennsfield Pl
Ste 110
Thousand Oaks, CA 91360

Ownership & related parties

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.

NameRoleSinceShare
Elaine Denise Shelton Individual 5% Or Greater Direct Ownership Interest Apr 14, 1992 51%
Corporate Officer Apr 14, 1992
Corporate Director Apr 14, 1992
W-2 Managing Employee Apr 14, 1992
William Donley Individual 5% Or Greater Direct Ownership Interest Apr 14, 1992 49%
Corporate Officer Apr 14, 1992
Corporate Director Apr 14, 1992

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1508819020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MOODY COURT SUITE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606067",
            "telephone_number": "805-371-9988",
            "fax_number": "805-371-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 MOODY COURT",
            "address_2": "SUITE 203",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606067",
            "telephone_number": "805-379-3031",
            "fax_number": "805-371-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAFF ASSISTANCE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STAFF ASSISTANCE, INC.",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "KERSWILL",
        "authorized_official_first_name": "GERD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-371-9988",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "9800879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA57514F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASSISTED HEALTHCARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ASSISTED HEALTHCARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.