Paul's Farm Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

679333 Issued in TX

Legal business name

PAUL'S FARM INC.

Doing business as

A&G Personal Provider Services

Practice address

318 Waterfront Dr Ste a
Seabrook, TX 77586-3923

Phone

(281) 474-2277

Fax

(281) 474-2287

NPI assigned

Nov 30, 2006

Last updated

Dec 14, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

PAUL'S FARM INC.As reported in NPPES

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

Authorized official

Name

Mrs. Teresita T. Bartolome, DN

Title

Administrator

Phone

(281) 474-2277

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• A&G Personal Provider Services Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649348640. Details of each certification follow.

• CCN 679333 Home health agency · Active · Details

Home health agency certification: CCN 679333

Legal name

PAUL'S FARM INC.

Doing business as

A & G PERSONAL PROVIDER SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 4, 2003

Last certification

Oct 2, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Aug 17, 1988 in TX

Enrollment address

318 Waterfront Dr
Ste a
Seabrook, TX 77586-3923

Listed as

A & G Personal Provider ServicesCCN 679333 · All quality measures

Ownership

Proprietary

Certified

Sep 4, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Part of

Paul's Farm Inc

Locations

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.

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1649348640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1064",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775861064",
            "telephone_number": "281-474-2277",
            "fax_number": "281-474-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 WATERFRONT DR STE A",
            "city": "SEABROOK",
            "state": "TX",
            "postal_code": "775863923",
            "telephone_number": "281-474-2277",
            "fax_number": "281-474-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL'S FARM INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAUL'S FARM INC.",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "BARTOLOME",
        "authorized_official_first_name": "TERESITA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-474-2277",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "679333",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "1003828",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10025075",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003828",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "82888",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000109100",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A&G Personal Provider Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A&G Personal Provider Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Seabrook, TX
• Providers in Seabrook, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.