NPIMap

Organization Active NPI

Mihom Healthcare Inc.

  • Home Health Agency
  • Port St Lucie, FL
National Provider Identifier
1730235276
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299991919 Issued in FL
Legal business name
MIHOM HEALTHCARE INC.
Practice address
2100 SE Hillmoor Dr Ste 102
Port St Lucie, FL 34952-8057
Phone
(772) 873-3838
Fax
(772) 873-3839
NPI assigned
Jan 26, 2007
Last updated
Oct 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Mrs. Susan F. Perry, MBA
Title
Administrator
Phone
(772) 873-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299991919 FL Primary

Addresses

Primary practice location

2100 SE Hillmoor Dr Ste 102
Port St Lucie, FL 34952-8057

Mailing address

2100 SE Hillmoor Dr
Suite102
Port St Lucie, FL 34952-8057
Phone (772) 873-3838

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000209 FL Part A Provider - Home Health Agency 4385627488 Practice locations: Port Saint Lucie, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730235276. Details of each certification follow.

Home health agency certification: CCN 108106

Legal name
MIHOM HEALTHCARE INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 13, 2004
Last certification
Mar 8, 2016
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 2, 2003 in FL
Enrollment address
2100 SE Hillmoor Dr
Ste 102
Port Saint Lucie, FL 34952-8057

Care Compare: Home health agency

Medicare Care Compare
Listed as
Parx Home Health CareCCN 108106 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Oct 13, 2004
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
10D1026020Mihom Healthcare Inc2100 SE Hillmoor Dr Ste 102, Port Saint Lucie, FL 34952Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory

Locations

2100 SE Hillmoor Dr
Ste 102
Port St Lucie, FL 34952
Phone (772) 873-3838

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Cheskel Spitzer Individual 5% Or Greater Indirect Ownership Interest Apr 20, 2023 100%
Corporate OfficerBoard Member Ceo Apr 20, 2023
Corporate DirectorBoard Member Ceo Apr 20, 2023
Parx Mihom Acquisition LLC Organization, Brooklyn, NY Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Apr 20, 2023 100%
Carrie Dupree Individual W-2 Managing EmployeeAdmin Feb 20, 2023

Practitioners & affiliated clinicians

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1730235276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR",
            "address_2": "SUITE102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "772-873-3838",
            "fax_number": "772-873-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "772-873-3838",
            "fax_number": "772-873-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIHOM HEALTHCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-873-3838",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299991919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.