Organization Active NPI

Specialty Home Care LLC

  • Respite Care
  • Washington, DC
National Provider Identifier
1619400058
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
SPECIALTY HOME CARE LLC
Practice address
6856 Eastern Ave NW Ste 376
Washington, DC 20012-2112
Phone
(202) 829-1719
Fax
(202) 722-4719
NPI assigned
Apr 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Authorized official

Name
Elias G DemozNPI 1518937473
Title
Ceo
Phone
(202) 829-1719

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X DC
Respite Care 385H00000X Primary

Addresses

Primary practice location

6856 Eastern Ave NW Ste 376
Washington, DC 20012-2112

Mailing address

6856 Eastern Ave NW Ste 376
Washington, DC 20012-2112
Phone (202) 829-1719

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170712000292 DC Part A Provider - Home Health Agency 6204105943 Practice locations: Washington, DC

Home health agency certification: CCN 097076

Legal name
SPECIALTY HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 6, 2017
Last certification
Oct 2, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
May 26, 2016 in DC
Enrollment address
6120 Kansas Ave NW
1St Floor
Washington, DC 20011-1531

Care Compare: Home health agency

Medicare Care Compare
Listed as
Specialty Home Care LLCCCN 097076 · All quality measures
Ownership
Proprietary
Certified
Dec 6, 2017
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
09D2129806Specialty Home Care6120 Kansas Avenue, NW 1St Floor, Washington, DC 20011Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory

Locations

6856 Eastern Ave NW
Ste 376
Washington, DC 20012
Phone (202) 829-1707

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
Elias G Demoz Individual 5% Or Greater Direct Ownership Interest May 6, 2016 100%
W-2 Managing EmployeeCeo/Administrator May 26, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647820800000",
    "number": "1619400058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 EASTERN AVE NW STE 376",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200122112",
            "telephone_number": "202-829-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 EASTERN AVE NW STE 376",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200122112",
            "telephone_number": "202-829-1719",
            "fax_number": "202-722-4719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "DEMOZ",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-829-1719"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.