NPIMap

Organization Active NPI

St.Mary's Home Health Services,Inc.

  • Home Health Agency
  • Fresno, CA
National Provider Identifier
1669560801
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
040000544 Issued in CA
Legal business name
ST.MARY'S HOME HEALTH SERVICES,INC.
Practice address
3180 E Shields Ave Ste 105
Fresno, CA 93726-6900
Phone
(559) 221-9919
Fax
(559) 221-9939
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Svetlana Krboyan
Title
President/Ceo
Phone
(559) 221-9919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 040000544 CA Primary

Addresses

Primary practice location

3180 E Shields Ave Ste 105
Fresno, CA 93726-6900

Mailing address

3180 E Shields Ave Ste 105
Fresno, CA 93726-6900
Phone (559) 221-9919

Other identifiers 2

IdentifierTypeStateIssuer
BLUE SHIELDOtherCAPROVIDER
HHA08195FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030124000017 CA Part A Provider - Home Health Agency 3577471275 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669560801. Details of each certification follow.

Home health agency certification: CCN 058195

Legal name
ST.MARY'S HOME HEALTH SERVICES,INC.
Doing business as
ST. MARY'S HOME HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 23, 2003
Last certification
Oct 31, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 6, 2002 in CA
Enrollment address
3180 E Shields Ave
Ste 105
Fresno, CA 93726-6900

Care Compare: Home health agency

Medicare Care Compare
Listed as
St Mary's Home Health Services, IncCCN 058195 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Sep 23, 2003
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
05D1013787St Marys Home Health Services Inc3180 E Shields Ave #105, Fresno, CA 93726Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory

Locations

1477 E Shaw Ave
Ste 101
Fresno, CA 93710
Phone (559) 221-9919

3180 E Shields Ave
Ste 105
Fresno, CA 93726
Phone (559) 221-9919

Ownership & related parties

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.

NameRoleSinceShare
Svetlana Krboyan Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Apr 11, 2007 100%
Corporate OfficerPresident/Ceo Apr 11, 2007 100%
Corporate DirectorPresident/Ceo Apr 11, 2007 100%
W-2 Managing Employee Oct 8, 2003

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1669560801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 E SHIELDS AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266900",
            "telephone_number": "559-221-9919",
            "fax_number": "559-221-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 E SHIELDS AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266900",
            "telephone_number": "559-221-9919",
            "fax_number": "559-221-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.MARY'S HOME HEALTH SERVICES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "KRBOYAN",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "559-221-9919"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "040000544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "BLUE SHIELD",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08195F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.