Capri Home Health Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CAPRI HOME HEALTH AGENCY, INC.

Practice address

5123 W Sunset Blvd
Suite 201
Los Angeles, CA 90027-5779

Phone

(323) 644-8282

Fax

(323) 644-8838

NPI assigned

Jul 5, 2005

Last updated

Aug 22, 2020By 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

Tereza Badroumian

Title

President

Phone

(323) 644-8282

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639176605. Details of each certification follow.

• CCN 058104 Home health agency · Active · Details

Home health agency certification: CCN 058104

Legal name

CAPRI HOME HEALTH AGENCY, INC.

Doing business as

PROLIFE HOME HEALTH CORPORATION

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 5, 2002

Last certification

Apr 3, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 1, 2001 in CA

Enrollment address

3425 Pomona Blvd
Ste D
Pomona, CA 91768-3258
HHA Branch

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Capri Home Health Agency, Inc.

  dba Prolife Home Health Corporation

  • Home Health Agency
  • Walnut, CA
  • NPI 1710996798

  O20060818000549

  Same enrollment

Listed as

Prolife Home Health CorporationCCN 058104 · All quality measures

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Mar 5, 2002

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.

Affiliated clinicians 4

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

• Lucita Menchavez Cruz, MD

  • Internal Medicine Physician
  • Norwalk, CA
  • NPI 1770526477

  Home health agency

  Care Compare affiliation
• Narayanaiyengar Ramanna Devaraj, MD

  • Cardiovascular Disease Physician
  • Anaheim, CA
  • NPI 1639133960

  Home health agency

  Care Compare affiliation
• Rizwana Begum Hussain, M.D.

  • General Practice Physician
  • Rowland Heights, CA
  • NPI 1548472574

  Home health agency

  Care Compare affiliation
• Mercedes Blasco Samson, M.D.

  • Family Medicine Physician
  • Buena Park, CA
  • NPI 1578605226

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639176605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 W SUNSET BLVD",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275779",
            "telephone_number": "323-644-8282",
            "fax_number": "323-644-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 W SUNSET BLVD",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275779",
            "telephone_number": "323-644-8282",
            "fax_number": "323-644-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPRI HOME HEALTH AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BADROUMIAN",
        "authorized_official_first_name": "TEREZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-644-8282"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "058104",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Cappetta
• Kaitlin Danielle Cappetto, DO
• Matthew Macmillan Cappiello, MD
• Leah Alaine Riggs Capra, AGACNP-BC
• Silviana Capra, LMFT
• Joseph Caprioli, MD
• Briana Caprow
• Capsule Los Angeles LLC (Capsule Pharmacy)
• Toni A Captain, PT
• Lourdes Bueno Capulong, D.D.S.

• Home Health Agency in Los Angeles, CA
• Providers in Los Angeles, 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 Aug 22, 2020; 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.