Practicare Home Health Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980000918 Issued in CA

Legal business name

PRACTICARE HOME HEALTH AGENCY

Practice address

223 North First Ave.
Suite 103
Arcadia, CA 91006

Phone

(626) 821-4880

Fax

(626) 821-4477

NPI assigned

Oct 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Erich Chan

Title

Cfo

Phone

(626) 821-4880

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 557550

Legal name

PRACTICARE HOME HEALTH AGENCY

Doing business as

PRACTICARE HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 21, 1995

Last certification

Aug 9, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Aug 14, 1996 in CA

Enrollment address

223 N 1St Ave
Ste 103
Arcadia, CA 91006-7027

Listed as

Practicare Home Health AgencyCCN 557550

Overall star rating

5 of 5

Ownership

Proprietary

Certified

Jun 21, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Jennifer O Ty-de Guzman, MSN, FNP,DNP,PMHNP

  • Home Health Registered Nurse
  • Paramount, CA
  • NPI 1790304194

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

Affiliated clinicians 1

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

• Dennis S Liu, MD

  • Internal Medicine Physician
  • Arcadia, CA
  • NPI 1629164520

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1639167208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 NORTH FIRST AVE.",
            "address_2": "SUITE 103",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-821-4880",
            "fax_number": "626-821-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 NORTH FIRST AVE.",
            "address_2": "SUITE 103",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91006",
            "telephone_number": "626-821-4880",
            "fax_number": "626-821-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTICARE HOME HEALTH AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "ERICH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "626-821-4880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980000918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA57550F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson Senkwan Pou, PSY.D.
• Morris Powazek, PHD
• Brandi Powell, PT/DPT
• Mary V Powell, RN
• Thomas William Powers, M.D.
• Imelda Prado
• Pratap Saraf MD, Inc.
• Rebecca Pratt
• Jasmine Preciado
• Premenstrual Syndrome Treatment Center

• Home Health Agency in Arcadia, CA
• Providers in Arcadia, 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 Jul 17, 2012; 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.