NPIMap

Organization Active NPI

Millennium Home Care LLC

  • Home Health Agency
  • Port Charlotte, FL
National Provider Identifier
1700058583
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299993118 Issued in FL
Legal business name
MILLENNIUM HOME CARE LLC
Practice address
1500 Kings Highway
Port Charlotte, FL 33980
Phone
(855) 674-7500
Fax
(855) 674-7501
NPI assigned
Apr 1, 2008
Last updated
Oct 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Authorized official

Name
Ms. Jessica Reis-Coelho, L.P.N
Title
Administrator
Phone
(855) 674-7501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299993118 FL Primary

Addresses

Primary practice location

1500 Kings Highway
Port Charlotte, FL 33980

Mailing address

1500 Kings Highway
Port Charlotte, FL 33980
Phone (855) 674-7500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080724000104 FL Part A Provider - Home Health Agency 4981777950 Practice locations: Port Charlotte, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700058583. Details of each certification follow.

Home health agency certification: CCN 109401

Legal name
MILLENNIUM HOME CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 8, 2009
Last certification
Jan 8, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 10, 2007 in FL
Enrollment address
1500 Kings Hwy
Port Charlotte, FL 33980-5231

Care Compare: Home health agency

Medicare Care Compare
Listed as
Millennium Home Care LLCCCN 109401 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jun 8, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
10D1082940Millennium Home Care LLC1500 Kings Hwy, Port Charlotte, FL 33980Certificate of waiverApr 22, 2028

National Provider Directory

National Provider Directory

Locations

2351 Aaron St
Port Charlotte, FL 33952
Phone (855) 979-5700

1500 Kings Hwy
Punta Gorda, FL 33980
Phone (855) 674-7500

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Millennium Home Health Holdings LLC Organization, Fort Myers, FL LLC 5% Or Greater Direct Ownership Interest Mar 7, 2013 100%
Kevin Kearns Individual Corporate Officer Apr 22, 2016
Operational/Managerial Control Apr 22, 2016
Millennium Healthcare Management Services, LLC Organization, Fort Myers, FL LLC, Management services company, For-profit Operational/Managerial Control May 11, 2021
Brian Fox Individual Operational/Managerial Control Apr 19, 2017
Arie P Dosoretz Individual 5% Or Greater Indirect Ownership Interest May 12, 2021
Jeffrey Pakrosnis Individual Corporate OfficerTreasurer Apr 19, 2017
Operational/Managerial Control Apr 19, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 245

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

View all 245

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1700058583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 KINGS HIGHWAY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33980",
            "telephone_number": "855-674-7500",
            "fax_number": "855-674-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 KINGS HIGHWAY",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33980",
            "telephone_number": "855-674-7500",
            "fax_number": "855-674-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "REIS-COELHO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "855-674-7501",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.P.N"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.