Blueridge Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLUERIDGE HOME HEALTH CARE LLC

Practice address

3430 E Flamingo Rd Ste 311F
Las Vegas, NV 89121-5067

Phone

(626) 278-8229

NPI assigned

Mar 21, 2025

Organization subpart

No

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

Authorized official

Name

Andrea Pena Agcaoili

Title

Administrator

Phone

(626) 278-8229

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Home health agency certification: CCN 297387

Legal name

BLUERIDGE HOME HEALTH CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 15, 2025

Last certification

Oct 15, 2025

Organization structure

LLCProprietary

Enrollment address

3430 E Flamingo Rd
Ste 311F
Las Vegas, NV 89121

Listed as

Blueridge Home Health Care LLCCCN 297387

Ownership

-

Certified

Oct 15, 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.

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1598566960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 311F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215067",
            "telephone_number": "626-278-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 311F",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215067",
            "telephone_number": "626-278-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUERIDGE HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "AGCAOILI",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "PENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-278-8229"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.