Prohealth Home Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROHEALTH HOME CARE INC

Practice address

2125 Oak Grove Rd Ste 124a
Walnut Creek, CA 94598-2534

Phone

(877) 258-0336

Fax

(408) 451-9217

NPI assigned

Dec 27, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Mohamed Shahram Marleen

Title

President

Phone

(408) 451-9055

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551641

Legal name

PROHEALTH HOME CARE, INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 3, 2012

Last certification

Aug 1, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jun 1, 2007 in CA

Enrollment address

2125 Oak Grove Rd
Ste 124a
Walnut Creek, CA 94598-2534

Other NPIs with the same Medicare PAC ID 5

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

• Prohealth Home Care Inc

  • Community Based Hospice Care Agency
  • Sacramento, CA
  • NPI 1497284145

  4183715188

  Same PAC ID
• Prohealth Home Care, Inc

  • Home Health Agency
  • Sacramento, CA
  • NPI 1215375175

  4183715188

  Same PAC ID
• Prohealth Home Care, Inc

  • Home Health Agency
  • Stockton, CA
  • NPI 1538507587

  4183715188

  Same PAC ID
• Prohealth Home Care, Inc

  • Home Health Agency
  • Stockton, CA
  • NPI 1952855447

  4183715188

  Same PAC ID
• Prohealth Home Care, Inc.

  • Home Health Agency
  • San Jose, CA
  • NPI 1255531570

  4183715188

  Same PAC ID

Listed as

Prohealth Home Care, IncCCN 551641

Ownership

For-Profit

Certified

Jul 3, 2012

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

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

• Rosalinda Arleen Mandreza, MD

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1336197185

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Ronak Patel, M.D.

  • Hematology & Oncology Physician
  • Walnut Creek, CA
  • NPI 1255872602

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1689943243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 OAK GROVE RD STE 124A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982534",
            "telephone_number": "877-258-0336",
            "fax_number": "408-451-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 OAK GROVE RD STE 124A",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982534",
            "telephone_number": "877-258-0336",
            "fax_number": "408-451-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "MARLEEN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "SHAHRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-451-9055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Price
• Keiala Price, N.P.
• Logan Price
• Primary Care of Walnut Creek
• Stewart Proctor, PH.D.
• Prometheus Medical Innovations a California Professional Medical Co
• Prosperity Therapy Services, Inc.
• Rayvon Prosser-Smith
• Nick Prouty
• Mark J. Provda, MD

• Home Health Agency in Walnut Creek, CA
• Providers in Walnut Creek, 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 Mar 20, 2024; 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.