Supreme Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPREME HOME HEALTH CARE INC

Practice address

1110 N Western Ave Ste 204
Los Angeles, CA 90029-1087

Phone

(323) 641-7177

Fax

(323) 840-3252

NPI assigned

Aug 26, 2022

Last updated

Aug 26, 2022By 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

Avetis Kebabjyan

Title

Ceo

Phone

(323) 641-7177

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 1568181063. Details of each certification follow.

• CCN 758052 Home health agency · Active · Details

Home health agency certification: CCN 758052

Legal name

SUPREME HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 21, 2025

Last certification

May 13, 2025

Organization structure

CorporationProprietary

Enrollment address

1110 N Western Ave
Ste 204
Los Angeles, CA 90029-1087
HHA Branch

Listed as

Supreme Home Health Care IncCCN 758052 · All quality measures

Ownership

-

Certified

May 21, 2025

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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

• Nabila Erian Gindi, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1346278124

  Home health agency

  Care Compare affiliation
• Vivian Magdi Gindi, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1679788764

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1568181063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N WESTERN AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291087",
            "telephone_number": "323-641-7177",
            "fax_number": "323-840-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N WESTERN AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291087",
            "telephone_number": "323-641-7177",
            "fax_number": "323-840-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "KEBABJYAN",
        "authorized_official_first_name": "AVETIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-641-7177"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supplemental Health Care (SHC)
• Support Home Health Care Inc
• Supportive Care of California PC
• Supportive Care Specialists
• Ruth Ann Supranovich, LCSW, EDD
• Chairat Supsin, PHARM.D.
• Elyssa Lirios Sur
• Melissa Sur
• Amit Sailesh Sura, M.D.
• Tyler Dean Suran, APCC

• Home Health Agency in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 26, 2022; 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.