NPIMap

Organization Active NPI

Healthpeak Home Health, Inc.

  • Home Health Agency
  • El Centro, CA
National Provider Identifier
1609296318
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550001940 Issued in CA
Legal business name
HEALTHPEAK HOME HEALTH, INC.
Practice address
1486 S Imperial Ave
El Centro, CA 92243-4200
Phone
(760) 352-3108
Fax
(760) 352-3234
NPI assigned
Apr 21, 2014
Last updated
Dec 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Mr. Jeffrey Dulay ChanNPI 1770843112
Title
Director of Patient Care Services
Phone
(760) 336-9330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 550001940 CA Primary

Addresses

Primary practice location

1486 S Imperial Ave
El Centro, CA 92243-4200

Mailing address

1486 S Imperial Ave
El Centro, CA 92243-4200
Phone (760) 352-3108

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140918000630 CA Part A Provider - Home Health Agency 5395964647 Practice locations: El Centro, CA; La Mesa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609296318. Details of each certification follow.

Home health agency certification: CCN 059480

Legal name
HEALTHPEAK HOME HEALTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 12, 2013
Last certification
Feb 8, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 17, 2014 in CA
Enrollment address
1486S Imperial Ave
El Centro, CA 92243-4200

Care Compare: Home health agency

Medicare Care Compare
Listed as
Healthpeak Home Health IncCCN 059480 · All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Mar 12, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1450 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-3108

1486 S Imperial Ave
El Centro, CA 92243
Phone (760) 352-3108

Ownership & related parties

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.

NameRoleSinceShare
Jaymee Chan Individual 5% Or Greater Direct Ownership InterestSecretary Mar 22, 2014 40%
Corporate OfficerVice-President Aug 28, 2014 40%
W-2 Managing EmployeeAdministrator Mar 22, 2014 40%
Jeffrey Chan Individual 5% Or Greater Direct Ownership InterestPresident Mar 22, 2014 60%
Corporate OfficerPresident Aug 28, 2014 60%
W-2 Managing EmployeeDirector of Patient Care Service Mar 22, 2014 60%

Practitioners & affiliated clinicians

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.

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1609296318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1486 S IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434200",
            "telephone_number": "760-352-3108",
            "fax_number": "760-352-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 S IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434200",
            "telephone_number": "760-352-3108",
            "fax_number": "760-352-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHPEAK HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DULAY",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT CARE SERVICES",
        "authorized_official_telephone_number": "760-336-9330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550001940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.