Primary Care Homehealthcare Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRIMARY CARE HOMEHEALTHCARE INC

Practice address

14545 Friar Street
Suite 203-2
Van Nuys, CA 91411

Phone

(818) 795-2953

NPI assigned

Apr 11, 2019

Last updated

Apr 11, 2019By 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

Anna AdamyanNPI 1871212605

Title

Ceo

Phone

(818) 795-2953

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 1639632078. Details of each certification follow.

• CCN 559298 Home health agency · Active · Details

Home health agency certification: CCN 559298

Legal name

PRIMARY CARE HOMEHEALTHCARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 3, 2020

Last certification

Jul 3, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 10, 2019 in CA

Enrollment address

14545 Friar St
Ste 203-2
Van Nuys, CA 91411-2397
HHA Branch

Listed as

Primary Care Homehealthcare IncCCN 559298 · All quality measures

Overall star rating

1 of 5

Ownership

Proprietary

Certified

Jul 3, 2020

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 1

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.

• Anna Adamyan, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Northridge, CA
  • NPI 1871212605

  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.

• Anna Adamyan, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Northridge, CA
  • NPI 1871212605
  NPD (past) Authorized official

Affiliated clinicians 3

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

• David W. Dinwiddie, MD

  • Family Medicine Physician
  • Baldwin Park, CA
  • NPI 1679644587

  Home health agency

  Care Compare affiliation
• Matthew Lew, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1356792907

  Home health agency

  Care Compare affiliation
• Kenneth Baldemor Reyes, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1083907547

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1639632078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR STREET SUITE 203-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91411",
            "telephone_number": "818-795-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR STREET",
            "address_2": "SUITE 203-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91411",
            "telephone_number": "818-795-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HOMEHEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "ADAMYAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-795-2953"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deshonna Patrice Prescott, MSW
• Prescriptions Plus (PX Drugstore #2)
• Debora Adair Presser, LCSW
• Haley Preston-Hotaki, RN
• Isabel Adriana Carolina Prieto-Esparza
• Primary Care Hospice Inc.
• Primary Choice Home Health, Care Inc
• Primary Healthcare Medical Center
• Prime 1 Home Health
• Prime Care Services Inc

• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, 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 11, 2019; 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.