Organization Active NPI

Kamelya Home Health Inc

  • Home Health Agency
  • San Diego, CA
National Provider Identifier
1578986428
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
KAMELYA HOME HEALTH INC
Practice address
438 Camino del Rio S Ste 106
San Diego, CA 92108-3546
Phone
(619) 303-8341
Fax
(619) 303-8806
NPI assigned
Jan 29, 2014
Last updated
Jul 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Mr. Rodel R Agpaoa
Title
Administrator
Phone
(619) 303-8341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

438 Camino del Rio S Ste 106
San Diego, CA 92108-3546

Mailing address

438 Camino del Rio S Ste 106
San Diego, CA 92108-3546
Phone (619) 303-8341

Other identifiers 1

IdentifierTypeStateIssuer
550003062OtherCACA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141008001053 CA Part A Provider - Home Health Agency 9739309071 Practice locations: La Mesa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578986428. Details of each certification follow.

Home health agency certification: CCN 059661

Legal name
KAMELYA HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 11, 2015
Last certification
Aug 24, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
3835 Avocado Blvd
Ste 260
La Mesa, CA 91941-8524

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kamelya Home Health IncorporatedCCN 059661 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Aug 11, 2015
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
05D2083686Kamelya Home Health, Incorporated438 Camino del Rio S Ste 106, San Diego, CA 92108Certificate of waiverSep 9, 2026

National Provider Directory

National Provider Directory

Locations

3835 Avocado Blvd
Ste 260
La Mesa, CA 91941
Phone (619) 303-8341

438 Camino del Rio S
Ste 106
San Diego, CA 92108
Phone (619) 303-8341

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Corazon R Agpaoa Individual 5% Or Greater Direct Ownership Interest Feb 28, 2016 25%
Corporate OfficerExec VP Feb 28, 2016 25%
Corporate DirectorBoard of Director Dec 7, 2017 25%
Florino P Agpaoa Individual 5% Or Greater Direct Ownership Interest Dec 1, 2017 25%
Corporate OfficerTreasurer Exec VP Feb 28, 2016 25%
Corporate DirectorBoard of Director Feb 28, 2016 25%
Ferdinand R Agpaoa Individual 5% Or Greater Direct Ownership InterestChief Compliance Officer Feb 28, 2016 25%
Corporate OfficerCorporate Secretary Apr 8, 2014 100%
Corporate DirectorBoard of Directors Apr 8, 2014 25%
W-2 Managing EmployeeCompliance Officer Sep 9, 2014 100%
Rodel R Agpaoa Individual 5% Or Greater Direct Ownership InterestAdministrator Dec 1, 2017 25%
Corporate OfficerPresident Apr 8, 2014 100%
Corporate DirectorBoard Chair Apr 8, 2014 25%
W-2 Managing EmployeeAd;Ceo Sep 9, 2014 100%

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1578986428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 CAMINO DEL RIO S STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083546",
            "telephone_number": "619-303-8341",
            "fax_number": "619-303-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 CAMINO DEL RIO S STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083546",
            "telephone_number": "619-303-8341",
            "fax_number": "619-303-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMELYA HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "AGPAOA",
        "authorized_official_first_name": "RODEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-303-8341",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "550003062",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.