Organization Active NPI

Calcare Home Health Inc

  • Home Health Agency
  • Pomona, CA
National Provider Identifier
1710090402
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001578 Issued in CA
Legal business name
CALCARE HOME HEALTH INC
Practice address
520 E Foothill Blvd Ste D
Pomona, CA 91767-1200
Phone
(909) 622-6300
Fax
(909) 622-6363
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Mrs. Mary Jean Guanzon, RN
Title
Administrator
Phone
(909) 622-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001578 CA Primary

Addresses

Primary practice location

520 E Foothill Blvd Ste D
Pomona, CA 91767-1200

Mailing address

520 E Foothill Blvd Ste D
Pomona, CA 91767-1200
Phone (909) 622-6300

Other identifiers 1

IdentifierTypeStateIssuer
980001578OtherCAHOME HEALTH STATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030822000027 CA Part A Provider - Home Health Agency 7517878952 Practice locations: Pomona, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710090402. Details of each certification follow.

Home health agency certification: CCN 058351

Legal name
CALCARE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 11, 2006
Last certification
Jan 25, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
May 8, 2003 in CA
Enrollment address
520 E Foothill Blvd
Ste D
Pomona, CA 91767-1200
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Calcare Home Health IncCCN 058351 · All quality measures
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
Nov 11, 2006
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
05D1014328Calcare Home Health Inc520 E Foothill Blvd, Ste D, Pomona, CA 91767Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory

Locations

17139 Bellflower Blvd
Ste 202
Bellflower, CA 90706
Phone (562) 461-8833

10900 183rd St
Ste 280
Cerritos, CA 90703
Phone (562) 865-8600

520 E Foothill Blvd
Ste D
Pomona, CA 91767
Phone (909) 622-6300

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Ram P Jeereddy Individual Corporate OfficerVice President and Chief Operati May 1, 2015 30%
Corporate Director May 1, 2015 33%
Padma Rajan Individual Corporate OfficerChief Financial Officer May 1, 2015 30%
Corporate DirectorBoard of Director May 1, 2015 33%
Chuang-Ti Hung Individual 5% Or Greater Indirect Ownership Interest May 1, 2015 6.72%
Ricardo E Saca Individual 5% Or Greater Indirect Ownership Interest May 1, 2015 5.64%
Foothill Accountable Care Medical Group, Inc Organization, Pomona, CA Corporation 5% Or Greater Direct Ownership Interest May 1, 2015 100%
Adrienne M Walker Individual Corporate OfficerPresident and Chief Executive of May 1, 2015 40%
Corporate DirectorBoard of Director May 1, 2015 34%
Prasad a Jeereddi Individual 5% Or Greater Indirect Ownership Interest May 1, 2015 6.77%
Mary J Guanzon Individual Operational/Managerial ControlAdministrator Jun 22, 2016 50%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1710090402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E FOOTHILL BLVD STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671200",
            "telephone_number": "909-622-6300",
            "fax_number": "909-622-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E FOOTHILL BLVD STE D",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671200",
            "telephone_number": "909-622-6300",
            "fax_number": "909-622-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALCARE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "GUANZON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-622-6300",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH STATE LICENSE",
            "identifier": "980001578",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.