Active NPI
Gimag Healthcare
Doing business as GIMAG Home Health Care
- Home Health Agency
- Livermore, CA
National Provider Identifier
1538545835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- GIMAG HEALTHCARE
- Doing business as
- GIMAG Home Health Care
- Practice address
- 4047 1St St Ste 101&103
Livermore, CA 94551-4924 - Phone
- (259) 453-6169
- Fax
- (925) 493-7992
- NPI assigned
- Aug 10, 2015
- 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
- Mrs. Bridget Mabel Ekunboyejo, RN
- Title
- Ceo
- Phone
- (925) 453-6169
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
4047 1St St Ste 101&103
Livermore, CA 94551-4924
Mailing address
4047 1St St Ste 101&103
Livermore, CA 94551-4924
Phone (259) 453-6169
Other names 1
- GIMAG Home Health Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160916000023 | CA | Part A Provider - Home Health Agency | 0749450849 | Practice locations: Livermore, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1538545835. Details of each certification follow.
Home health agency certification: CCN 059787
- Legal name
- GIMAG HEALTHCARE
- Doing business as
- GIMAG HOME HEALTH CARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 26, 2017
- Last certification
- Oct 8, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Nov 3, 2008 in CA
- Enrollment address
- 4047 1St St
Ste 101
Livermore, CA 94551-1462
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba GIMAG Hospice & Palliative Care (GIMAG HPC)
- Community Based Hospice Care Agency
- Livermore, CA
- NPI 1659852119
0749450849
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Gimag Home Health Care
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 26, 2017
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Gimag Healthcare
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba GIMAG Hospice & Palliative Care (GIMAG HPC)
- Community Based Hospice Care Agency
- Livermore, CA
- NPI 1659852119
Locations
4047 1st St
Ste 101103
Livermore, CA 94551
Phone (259) 453-6169
4047 1st St
Ste 101
Livermore, CA 94551
Phone 9254536169102
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Bridget Ekunboyejo | 5% Or Greater Direct Ownership Interest | Nov 3, 2008 | 51% |
| Corporate Officer | Aug 1, 2015 | 51% | |
| Corporate Director | Nov 3, 2008 | ||
| W-2 Managing Employee | Aug 1, 2015 | ||
| Olubusayo Ekunboyejo | 5% Or Greater Direct Ownership Interest | Nov 3, 2008 | 49% |
| Corporate Officer | Aug 1, 2015 | 49% | |
| Corporate Director | Aug 1, 2015 |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Walnut Creek, CA
- NPI 1376173476
Home health agency
-
- Emergency Medicine Physician
- Alameda, CA
- NPI 1003836594
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694736000000",
"number": "1538545835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4047 1ST ST STE 101&103",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945514924",
"telephone_number": "259-453-6169",
"fax_number": "259-493-7992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4047 1ST ST STE 101&103",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945514924",
"telephone_number": "259-453-6169",
"fax_number": "925-493-7992"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GIMAG HEALTHCARE",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-10",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A",
"authorized_official_last_name": "EKUNBOYEJO",
"authorized_official_first_name": "BRIDGET",
"authorized_official_middle_name": "MABEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "925-453-6169",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "GIMAG Home Health Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "GIMAG Home Health Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.