Apache Healthcare Services Inc.
Organization Active NPI Home Health Agency · Gilbert, AZ
NPI 1760449409 · NPPES record last updated Sep 14, 2020
Key facts
- NPI
- 1760449409
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- HHA3958 (AZ)
- Legal business name
- APACHE HEALTHCARE SERVICES INC.
- Practice address
- 105 N. Pasadena St.
Ste 2
Gilbert, AZ 85233-5013 - Phone
- (480) 926-0133
- Fax
- (480) 926-6377
- NPI assigned
- Apr 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Tarik M Shirif
- Title
- Ceo, President
- Phone
- (480) 246-3593
Corporate family (same tax ID) 1
Practitioners 2
-
Khalid M Shirif, M.D.
Affiliated clinicians 51
-
Jaber Abawi, MD
-
Sara Leah Allen, PAC
-
Shilpa Bhatnagar, M. D.
-
Amanda Chargualaf, FNP
-
Eunmee P Chung, DNP
-
Pete S Coury, MD
-
Michael D Dersam, MD
-
Roxanna Donan, FNP-C
-
Jason Elkan, FNP
-
Lalith Kumar Gande, M.D.
-
Kerry Scott Green, M.D.
-
Darcie M. Groeper, D.O.
-
Kelly P Harte, FNP-BC
-
Bradley Hughes, M.D.
-
Philip L Ku, M.D.
-
Salvatore G Lacognata, D.O.
Medicare Care Compare: Home health agency
- Listed as
- Sunrise Health Services
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Jan 7, 2004
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Home health agency certification: CCN 037226
- Legal name
- APACHE HEALTHCARE SERVICES INC
- Doing business as
- SUNRISE HEALTH SERVICES
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 7, 2004
- Last certification
- Mar 26, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 105 N Pasadena St
Ste 2
Gilbert, AZ 85233-5013
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Brightlife Home Health Care LLC |
5% Or Greater Direct Ownership Interest | Dec 31, 2023 | 100% |
| Tarik M Shirif |
5% Or Greater Indirect Ownership Interest | Dec 31, 2023 | 50.1% |
| Corporate Officer |
Dec 31, 2023 | 50.1% | |
| Corporate Director |
Dec 31, 2023 | 50.1% | |
| Joshua Smith |
5% Or Greater Indirect Ownership Interest |
Dec 31, 2023 | 49.9% |
| Corporate Officer | Dec 31, 2023 | ||
| Corporate Director |
Dec 31, 2023 | 49.9% | |
| W-2 Managing Employee | Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000711 | AZ | Part a Provider - Home Health Agency | 5799697298 | Practice locations: Gilbert, AZ |
National Provider Directory
- Tax ID family
- Apache Healthcare Services Inc
Locations
105 N Pasadena St
Ste 2
Gilbert, AZ 85233
Phone (480) 926-0133
962 E Isabella Ave
Mesa, AZ 85204
Phone (480) 926-0133
1840 E University Dr
Ste 1
Mesa, AZ 85203
Phone (480) 246-3593
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HHA3315 | AZ | |
| Home Health Agency | 251E00000X | HHA3958 | AZ | Yes |
Addresses
Primary practice location
105 N. Pasadena St.
Ste 2
Gilbert, AZ 85233-5013
Mailing address
105 N. Pasadena St.
Ste 2
Gilbert, AZ 85233-5013
Phone (480) 926-0133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0209350 | Other | AZ | BC/BS OF AZ |
| 923567 | Medicaid | AZ | |
| AZ0039710 | Other | AZ | BC/BS DME |
Other names
- Sunrise Health Services
Other providers in Gilbert, AZ
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- Aom Infusion Centers of Arizona PC
- Apache Oxy-Med Inc
- Liezl Apante
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- Apex Dental Care, P.C.
- Apex Endodontics
All providers in Gilbert, AZ · Home Health Agency in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2020. 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.