Active NPI
Unified Care Providers, Inc.
- Home Health Agency
- Irvine, CA
National Provider Identifier
1689997215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- UNIFIED CARE PROVIDERS, INC.
- Practice address
- 1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748 - Phone
- (949) 788-0907
- Fax
- (949) 681-8326
- NPI assigned
- Mar 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Farzad Afravi, LVN
- Title
- Cfo/Administrator
- Phone
- (949) 788-0907
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748
Mailing address
1 Peters Canyon Rd Ste 160B
Irvine, CA 92606-1748
Phone (949) 788-0907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110208000222 | CA | Part A Provider - Home Health Agency | 7416137567 | Practice locations: Irvine, CA |
Home health agency certification: CCN 059390
- Legal name
- UNIFIED CARE PROVIDERS, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 11, 2012
- Last certification
- Feb 8, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Sep 11, 2009 in CA
- Enrollment address
- 1 Peters Canyon Rd
Ste 160B
Irvine, CA 92606-1748
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Unified Care Providers, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jan 11, 2012
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2016243 | Unified Care Providers Inc | Certificate of waiver | Nov 14, 2026 |
National Provider Directory
National Provider DirectoryLocations
15775 Laguna Canyon Rd
Ste 180
Irvine, CA 92618
Phone (949) 788-0907
1 Peters Canyon Rd
Ste 160B
Irvine, CA 92606
Phone (949) 788-0907
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Yong B Jun | 5% Or Greater Direct Ownership Interest | Oct 15, 2012 | 75% |
| Corporate Officer | Jul 22, 2019 | 25% | |
| W-2 Managing Employee | Oct 15, 2012 | 25% | |
| Operational/Managerial Control | Oct 15, 2012 | 25% | |
| Farzad Afravi | 5% Or Greater Direct Ownership Interest | Jul 22, 2019 | 50% |
| Corporate Officer | Jul 22, 2019 | 50% | |
| Corporate Director | Jul 22, 2019 | 50% | |
| W-2 Managing Employee | Jul 22, 2019 | 50% | |
| Operational/Managerial Control | Jul 22, 2019 | 50% | |
| Shohreh Forouzanfar | Corporate Officer | Jul 22, 2019 | 25% |
| Corporate Director | Jul 22, 2019 | 25% | |
| W-2 Managing Employee | Jul 22, 2019 | 25% | |
| Operational/Managerial Control | Jul 22, 2019 | 25% | |
| Soo Yeoun Kim | 5% Or Greater Direct Ownership Interest | Sep 14, 2009 | 25% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268179200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691971200000",
"number": "1689997215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PETERS CANYON RD STE 160B",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061748",
"telephone_number": "949-788-0907",
"fax_number": "949-681-8326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PETERS CANYON RD STE 160B",
"city": "IRVINE",
"state": "CA",
"postal_code": "926061748",
"telephone_number": "949-788-0907",
"fax_number": "949-681-8326"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIFIED CARE PROVIDERS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-10",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A",
"authorized_official_last_name": "AFRAVI",
"authorized_official_first_name": "FARZAD",
"authorized_official_title_or_position": "CFO/ADMINISTRATOR",
"authorized_official_telephone_number": "949-788-0907",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LVN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.