Huntingdon Valley Homecare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

HUNTINGDON VALLEY HOMECARE LLC

Doing business as

Huntingdon Valley Hospice

Practice address

995 Jaymor Rd
Suite #2
Southampton, PA 18966-3855

Phone

(267) 279-9113

NPI assigned

Jun 3, 2015

Last updated

Dec 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig Miller, MSNNPI 1932139045

Title

Owner/Administrator

Phone

(267) 279-9113

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Huntingdon Valley Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1538549787. Details of each certification follow.

• CCN 398283 Home health agency · Active · Details

Home health agency certification: CCN 398283

Legal name

HUNTINGDON VALLEY HOME CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 23, 2018

Last certification

Feb 23, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 11, 2015 in PA

Enrollment address

995 Jaymor Rd
Ste 2
Southampton, PA 18966-3855

Listed as

Huntingdon Valley Home Care LLCCCN 398283 · All quality measures

Ownership

Proprietary

Certified

Feb 23, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Occupational therapy

Locations

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.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Craig Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Meadowbrook, PA
  • NPI 1932139045
  NPD Authorized official

Affiliated clinicians 2

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

• Benjamin Z Bennov, MD

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1083603104

  Home health agency

  Care Compare affiliation
• Leah Sorokorensky, CRNP

  • Acute Care Nurse Practitioner
  • Plymouth Meeting, PA
  • NPI 1902169642

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1538549787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 JAYMOR RD",
            "address_2": "SUITE #2",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663855",
            "telephone_number": "267-279-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 JAYMOR RD",
            "address_2": "SUITE #2",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663855",
            "telephone_number": "267-279-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTINGDON VALLEY HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "267-279-9113",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031961930002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE",
            "identifier": "004121396",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntingdon Valley Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.