NPIMap

Organization Active NPI

Extended Home Health Services, Inc.

  • Home Health Agency
  • Miami, FL
National Provider Identifier
1699952200
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299993010 Issued in FL
Legal business name
EXTENDED HOME HEALTH SERVICES, INC.
Practice address
945 SW 87TH Ave # a
Miami, FL 33174-3206
Phone
(305) 553-1003
Fax
(305) 553-1007
NPI assigned
Jan 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Mr. Jorge Perera, RN
Title
President
Phone
(305) 553-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299993010 FL Primary

Addresses

Primary practice location

945 SW 87TH Ave # a
Miami, FL 33174-3206

Mailing address

945 SW 87TH Ave # a
Miami, FL 33174-3206
Phone (305) 553-1003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081007000107 FL Part A Provider - Home Health Agency 5395813166 Practice locations: Miami, FL

Home health agency certification: CCN 109408

Legal name
EXTENDED HOME HEALTH SERVICES,INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 26, 2009
Last certification
May 29, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 26, 2007 in FL
Enrollment address
945 SW 87 Ave
Suite a
Miami, FL 33174-2947

Care Compare: Home health agency

Medicare Care Compare
Listed as
Extended Home Health Services IncCCN 109408
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jul 26, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
10D1079192Extended Home Health Services Inc945 SW 87 Ave # a, Miami, FL 33174Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Locations

945 SW 87th Ave
#A
Miami, FL 33174
Phone (305) 262-8053

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
Ana Alfonso Individual Contracted Managing Employee Oct 17, 2011
5% Or Greater Direct Ownership Interest May 10, 2023 50%
W-2 Managing Employee Feb 1, 2008
Jorge Perera Individual 5% Or Greater Direct Ownership Interest May 10, 2023 50%
Corporate Officer Apr 26, 2007 100%
Corporate Director Feb 1, 2008 100%
W-2 Managing Employee Feb 1, 2008 100%

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1699952200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 SW 87TH AVE # A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743206",
            "telephone_number": "305-553-1003",
            "fax_number": "305-553-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 SW 87TH AVE # A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331743206",
            "telephone_number": "305-553-1003",
            "fax_number": "305-553-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "PERERA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-553-1003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.