NPIMap

Organization Active NPI

Golden Age Home Health LLC

  • Home Health Agency
  • Bargersville, IN
National Provider Identifier
1730457698
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOLDEN AGE HOME HEALTH LLC
Practice address
5080 N State Road 135 Ste F
Bargersville, IN 46106-8941
Phone
(317) 893-2449
Fax
(317) 893-2675
NPI assigned
Dec 7, 2011
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Tushar P LotheNPI 1891332532
Title
President
Phone
(317) 694-5767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

5080 N State Road 135 Ste F
Bargersville, IN 46106-8941

Mailing address

5080 N State Road 135 Ste F
Bargersville, IN 46106-8941
Phone (317) 893-2449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000497 IN Part A Provider - Home Health Agency 1355502097 Practice locations: Bargersville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730457698. Details of each certification follow.

Home health agency certification: CCN 157654

Legal name
GOLDEN AGE HOME HEALTH LLC
Doing business as
CENTER GROVE HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 4, 2013
Last certification
Jan 5, 2013
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 23, 2011 in IN
Enrollment address
5080 N State Road 135
Ste F
Bargersville, IN 46106-8941

Care Compare: Home health agency

Medicare Care Compare
Listed as
Golden Age Home Health Care LLCCCN 157654 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jan 4, 2013
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
15D2036567Golden Age Home Health Care, LLC5080 N State Road 135, Suite F, Bargersville, IN 46106Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory

Locations

5080 N State Road 135
Ste F
Bargersville, IN 46106
Phone (317) 893-2449

1711 S State Road 135
Ste A
Greenwood, IN 46143
Phone (317) 893-2449

Ownership & related parties

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.

NameRoleSinceShare
Tushar Prakash Lothe Individual 5% Or Greater Direct Ownership Interest Aug 23, 2011 100%
Corporate Director Aug 23, 2011
W-2 Managing Employee Aug 23, 2011

Owners & managing parties with NPI records 1

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

  • Tushar Prakash Lothe
    • Occupational Therapist
    • Bargersville, IN
    • NPI 1891332532

    5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 9

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": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1730457698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 N STATE ROAD 135 STE F",
            "city": "BARGERSVILLE",
            "state": "IN",
            "postal_code": "461068941",
            "telephone_number": "317-893-2449",
            "fax_number": "317-893-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 N STATE ROAD 135 STE F",
            "city": "BARGERSVILLE",
            "state": "IN",
            "postal_code": "461068941",
            "telephone_number": "317-893-2449",
            "fax_number": "317-893-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "LOTHE",
        "authorized_official_first_name": "TUSHAR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-694-5767"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bargersville, IN

Sources for this page

Verify at the official NPI Registry.