NPIMap

Organization Active NPI

Emerald Triune Home Health Services, Inc.

  • Home Health Agency
  • Escondido, CA
National Provider Identifier
1629348669
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EMERALD TRIUNE HOME HEALTH SERVICES, INC.
Practice address
330 W Felicita Ave
Ste. D6
Escondido, CA 92025-6533
Phone
(760) 294-9680
Fax
(760) 797-1860
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Ivy-Eileen Medina Samoy, R.N.
Title
Ceo/Administrator
Phone
(760) 294-9680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

330 W Felicita Ave
Ste. D6
Escondido, CA 92025-6533

Mailing address

330 W Felicita Ave
Ste. D6
Escondido, CA 92025-6533
Phone (760) 294-9680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120508000206 CA Part A Provider - Home Health Agency 9335301449 Practice locations: Escondido, CA

Home health agency certification: CCN 059493

Legal name
EMERALD TRIUNE HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 8, 2013
Last certification
Feb 21, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 2, 2012 in CA
Enrollment address
253 S Escondido Blvd
Escondido, CA 92025-4116

Care Compare: Home health agency

Medicare Care Compare
Listed as
Emerald Triune Home Health Services, IncCCN 059493
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 8, 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

253 S Escondido Blvd
Escondido, CA 92025
Phone (760) 294-9680

330 W Felicita Ave
Ste D6
Escondido, CA 92025
Phone (760) 294-9680

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Myrna F Arcelao Individual 5% Or Greater Direct Ownership Interest Jan 10, 2012 33.33%
Corporate OfficerTreasurer/Cfo Jan 10, 2012 33.33%
Corporate DirectorTreasurer/Board Member Jan 10, 2012 33.33%
W-2 Managing EmployeeCfo/Treasurer Jan 10, 2012 33.33%
Operational/Managerial ControlCfo Jan 10, 2012 33.33%
Maria C Udan Individual 5% Or Greater Direct Ownership Interest Jan 10, 2012 33.33%
Corporate OfficerSecretary Jan 10, 2012 33.33%
Corporate DirectorSecretary/Board Member Jan 10, 2012 33.33%
W-2 Managing EmployeeDirecotgr of Patient Care Servic Jan 10, 2012 33.33%
Operational/Managerial ControlDirector of Patient Care Service Jan 10, 2012 33.33%
Ivy-Eileen M Samoy Individual 5% Or Greater Direct Ownership Interest Jan 10, 2012 33.34%
Corporate OfficerPresident/Ceo Jan 10, 2012 33.34%
Corporate DirectorPresident/Board Member Jan 10, 2012 33.34%
W-2 Managing EmployeeCeo/Administrator Jan 10, 2012 33.34%
Operational/Managerial ControlCeo/Administrator Jan 10, 2012 33.34%

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1629348669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W FELICITA AVE",
            "address_2": "STE. D6",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256533",
            "telephone_number": "760-294-9680",
            "fax_number": "760-797-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W FELICITA AVE",
            "address_2": "STE. D6",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256533",
            "telephone_number": "760-294-9680",
            "fax_number": "760-797-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD TRIUNE HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "SAMOY",
        "authorized_official_first_name": "IVY-EILEEN",
        "authorized_official_middle_name": "MEDINA",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "760-294-9680",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.