NPIMap

Organization Active NPI

Genesis Home Health Services, Inc.

  • Home Health Agency
  • Winnemucca, NV
National Provider Identifier
1659645760
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5191HSB-4 Issued in NV
Legal business name
GENESIS HOME HEALTH SERVICES, INC.
Practice address
8TH East Haskell
Suite C
Winnemucca, NV 89445-3584
Phone
(775) 625-1002
Fax
(775) 625-2021
NPI assigned
Mar 7, 2012
Organization subpart
Yes
Parent organization
GENESIS HOME HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Authorized official

Name
Querubin Iguban
Title
Ceo
Phone
(775) 753-7626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5191HSB-4 NV Primary

Addresses

Primary practice location

8TH East Haskell
Suite C
Winnemucca, NV 89445-3584

Mailing address

2620 Ruby Vista Dr
Elko, NV 89801-1638
Phone (775) 753-7626

Other identifiers 1

IdentifierTypeStateIssuer
297300OtherNVMEDICARE PROVIDER NUMBER OR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100317000644 NV Part A Provider - Home Health Agency 3173580776 1 other NPI on this enrollment
Practice locations: Winnemucca, NV

Home health agency certification: CCN 297300

Legal name
GENESIS HOME HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 1, 2010
Last certification
Sep 19, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 14, 2004 in NV
Enrollment address
400 W 4TH St
Winnemucca, NV 89445-3325
HHA Branch

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Genesis Home Health ServicesCCN 297300
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Nov 1, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D1081342Genesis Home Health Services Inc-Winnemucca400 West 4TH St, Winnemucca, NV 89445Certificate of waiverMar 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Genesis Home Health Services Inc- Pca3 organizations share this tax ID, including this one
Part of
Genesis Home Health Services Inc- Pca

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

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.

NameRoleSinceShare
Querubin Iguban Individual 5% Or Greater Direct Ownership Interest Jun 14, 2004 50%
Corporate OfficerPresident Jun 14, 2004 50%
W-2 Managing EmployeeAdministrator/Ceo Jun 14, 2004 100%
Celestine Q Hernandez Individual 5% Or Greater Direct Ownership Interest Jun 14, 2004 50%
Corporate OfficerVice-Presidet Jun 14, 2004 50%
W-2 Managing EmployeeDirector Jun 14, 2004 100%

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1659645760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 RUBY VISTA DR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898011638",
            "telephone_number": "775-753-7626",
            "fax_number": "775-753-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH EAST HASKELL",
            "address_2": "SUITE C",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453584",
            "telephone_number": "775-625-1002",
            "fax_number": "775-625-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS HOME HEALTH SERVICES, INC.",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "IGUBAN",
        "authorized_official_first_name": "QUERUBIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-753-7626"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "5191HSB-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER OR PTAN",
            "identifier": "297300",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

Verify at the official NPI Registry.