Organization Active NPI

Palm Beach Home Health Inc

  • Home Health Agency
  • W Palm Beach, FL
National Provider Identifier
1558450643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PALM BEACH HOME HEALTH INC
Practice address
2150 S Congress Ave
W Palm Beach, FL 33406-4821
Phone
(561) 963-5544
Fax
(561) 963-1883
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Juan Rodriguez
Title
President
Phone
(561) 963-5544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X FL Primary

Addresses

Primary practice location

2150 S Congress Ave
W Palm Beach, FL 33406-4821

Mailing address

201 Ohio Rd
Lake Worth, FL 33467-4821
Phone (561) 963-5544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050228000932 FL Part A Provider - Home Health Agency 3072566264 Practice locations: West Palm Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558450643. Details of each certification follow.

Home health agency certification: CCN 108182

Legal name
PALM BEACH HOME HEALTH INC
Doing business as
PBH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 27, 2005
Last certification
Feb 5, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 12, 2003 in FL
Enrollment address
2150 S Congress Avenue
West Palm Beach, FL 33406

Care Compare: Home health agency

Medicare Care Compare
Listed as
Palm Beach Home Health IncCCN 108182 · All quality measures
Ownership
Proprietary
Certified
Jul 27, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1035892Palm Beach Home Health Inc2150 S Congress Ave, West Palm Beach, FL 33406Certificate of waiverJan 12, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Juan Rodriguez Individual 5% Or Greater Direct Ownership Interest Dec 12, 2003 100%
W-2 Managing Employee Apr 30, 2012

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558450643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OHIO RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334674821",
            "telephone_number": "561-963-5544",
            "fax_number": "561-963-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 S CONGRESS AVE",
            "city": "W PALM BEACH",
            "state": "FL",
            "postal_code": "334064821",
            "telephone_number": "561-963-5544",
            "fax_number": "561-963-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-963-5544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.