Organization Active NPI

Sundance Home Care Inc.

  • Home Health Agency
  • Brooklyn, NY
National Provider Identifier
1760906390
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUNDANCE HOME CARE INC.
Practice address
504 Livonia Ave
Brooklyn, NY 11207-5248
Phone
(347) 796-1777
Fax
(718) 514-6434
NPI assigned
Jul 26, 2017
Organization subpart
Yes
Parent organization
SUNDANCE HOME CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Mr. Steven Metelsky
Title
Administartor
Phone
(347) 796-1777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

504 Livonia Ave
Brooklyn, NY 11207-5248

Mailing address

504 Livonia Ave
Brooklyn, NY 11207-5248
Phone (347) 796-1777

Other identifiers 1

IdentifierTypeStateIssuer
04708930MedicaidNY

Other names 1

  • Sundance Home Care CDPAS Other name

National Provider Directory

National Provider Directory
Tax ID family
Sundance Home Care Inc2 organizations share this tax ID, including this one
Part of
Sundance Home Care Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

561 Utica Ave
Brooklyn, NY 11203
Phone (305) 987-3636

504 Livonia Ave
Brooklyn, NY 11207
Phone (347) 796-1777

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1760906390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075248",
            "telephone_number": "347-796-1777",
            "fax_number": "718-514-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 LIVONIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112075248",
            "telephone_number": "347-796-1777",
            "fax_number": "718-514-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE HOME CARE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNDANCE HOME CARE, INC.",
        "enumeration_date": "2017-07-26",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "METELSKY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "ADMINISTARTOR",
        "authorized_official_telephone_number": "347-796-1777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04708930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Home Care CDPAS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sundance Home Care CDPAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.