Executive Home Health, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXECUTIVE HOME HEALTH, INC

Practice address

750 S Raymond Ave
Suite 123
Pasadena, CA 91105-3244

Phone

(626) 765-9202

Fax

(626) 765-9206

NPI assigned

Nov 1, 2011

Last updated

Apr 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Fraipont, MDNPI 1164418893

Title

Owner

Phone

(626) 765-9202

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629354808. Details of each certification follow.

• CCN 059541 Home health agency · Active · Details

Home health agency certification: CCN 059541

Legal name

EXECUTIVE HOME HEALTH, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 4, 2013

Last certification

Jun 5, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 19, 2011 in CA

Enrollment address

777 S Arroyo Pkwy
Ste 103
Pasadena, CA 91105-3907

Listed as

Executive Home Health, IncCCN 059541 · All quality measures

Overall star rating

5 of 5

Ownership

Proprietary

Certified

Jun 4, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

Owners & managing parties with NPI records 1

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

• Michael J Fraipont, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Pasadena, CA
  • NPI 1164418893

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control

  CMS ownership

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.

• Michael J Fraipont, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Pasadena, CA
  • NPI 1164418893
  NPD (past) Authorized official

Affiliated clinicians 5

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

• Roy Freedman Ashford, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Pasadena, CA
  • NPI 1588646368

  Home health agency

  Care Compare affiliation
• Todd B Dietrick, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Pasadena, CA
  • NPI 1619963444

  Home health agency

  Care Compare affiliation
• Steven J Hsu, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Pasadena, CA
  • NPI 1144547696

  Home health agency

  Care Compare affiliation
• Timothy J Jackson, M.D.

  • Orthopaedic Surgery Physician
  • Pasadena, CA
  • NPI 1245481266

  Home health agency

  Care Compare affiliation
• James Andrew O'Dowd, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Pasadena, CA
  • NPI 1093126336

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1629354808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S RAYMOND AVE",
            "address_2": "SUITE 123",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911093244",
            "telephone_number": "626-765-9202",
            "fax_number": "626-765-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S RAYMOND AVE",
            "address_2": "SUITE 123",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053244",
            "telephone_number": "626-765-9202",
            "fax_number": "626-765-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "FRAIPONT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-765-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.