Blue Star Home Care, LLC – Home Health Agency

Key facts

NPI: 1720510381
Entity type: Organization (NPI type 2)
Primary specialty: Home Health Agency 251E00000X
Legal business name: BLUE STAR HOME CARE, LLC
Practice address: 15644 Madison Ave Ste 106
Lakewood, OH 44107-5622
Phone: (216) 505-5789
Fax: (216) 505-5956
NPI assigned: Mar 31, 2017
Organization subpart: No

Authorized official

Name: Abdullahi A Ali
Title: Administrator
Phone: (216) 396-5051

Medicare Care Compare: Home health agency

Listed as: Blue Star Home Care LLC CCN 369210
Ownership: Proprietary
Certified: Mar 4, 2019
Medicare certification status: Active (Provider of Services file)
Services: Nursing, Home health aide, Physical therapy

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
36D2147262	Blue Star Home Care, LLC 15644 Madison Ave Suite 106, Lakewood, OH 44107	Certificate of waiver	Apr 16, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH

Home health agency certification: CCN 369210

Legal name: BLUE STAR HOME CARE LLC
Certification status: Active
Provider type (POS): Home health agency
Participating since: Mar 4, 2019
Last certification: Mar 4, 2019
Ownership / control type: Proprietary
Organization structure: LLC · Proprietary
Incorporated: Feb 15, 2017 in OH
Enrollment address: 15644 Madison Ave
Ste 106
Lakewood, OH 44107-5622

All disclosed owners & managing parties 1

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
Abdullahi Ali Individual	5% Or Greater Direct Ownership Interest	Feb 15, 2017
Abdullahi Ali Individual	Operational/Managerial Control	Feb 15, 2017

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20171016001055	OH	Part a Provider - Home Health Agency	3375819568	Practice locations: Lakewood, OH

National Provider Directory

Locations

24500 Center Ridge Rd
Ste 315
Westlake, OH 44145
Phone (440) 438-3133

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X			Yes

Addresses

Primary practice location

15644 Madison Ave Ste 106
Lakewood, OH 44107-5622

Mailing address

15644 Madison Ave Ste 106
Lakewood, OH 44107-5622
Phone (216) 505-5789

Other providers in Lakewood, OH

Steven Carl Blaha, M.D.
Kelly Blakely
Julie Ann Blantern
Marcus Blohm
Bloomfield Senior Living of Lakewood, LLC
Sarah Maame Boaitey, MD
Fratina Rochelle Boatman, RN
Candice Boddy, CNM
Victoria M. Bodner, L.M.T.
Laura Bolin

All providers in Lakewood, OH · Home Health Agency in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.