Elk Grove Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ELK GROVE HOME HEALTH INC

Doing business as

Elk Grove Home Health

Practice address

2386 Maritime Dr Ste 220
Elk Grove, CA 95758-3643

Phone

(916) 698-9803

Fax

(916) 880-5313

NPI assigned

May 26, 2021

Organization subpart

No

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

Authorized official

Name

Lusine Movsisyan

Title

Ceo/Cfo/Secretary

Phone

(916) 698-9803

Specialties & licenses 1

Addresses

Other names 1

• Elk Grove Home Health Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757267

Legal name

ELK GROVE HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 10, 2023

Last certification

Mar 23, 2023

Organization structure

CorporationProprietary

Incorporated

Nov 23, 2020 in CA

Enrollment address

2386 Maritime Dr
Ste 220
Elk Grove, CA 95758-3643

Listed as

Elk Grove Home Health, Inc.CCN 757267

Ownership

-

Certified

Apr 10, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

Affiliated clinicians 1

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

• Hussam Kujok, MD

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1013081611

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1780259150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 MARITIME DR STE 220",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957583643",
            "telephone_number": "916-698-9803",
            "fax_number": "916-880-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 MARITIME DR STE 220",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957583643",
            "telephone_number": "916-698-9803",
            "fax_number": "916-880-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "MOVSISYAN",
        "authorized_official_first_name": "LUSINE",
        "authorized_official_title_or_position": "CEO/CFO/SECRETARY",
        "authorized_official_telephone_number": "916-698-9803"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ElkGrove",
            "affiliation": "N",
            "endpointDescription": "Homehealthagency",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2386 Maritime Dr Ste 220",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957583643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Elk Grove Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elk Grove Dialysis Center LLC
• Elk Grove Family Physicians Medical Group Inc
• Elk Grove Foot and Ankle PC
• Elk Grove Hearing Care
• Elk Grove Hearing Clinic, Inc.
• Elk Grove Medical & Dental Supply
• Elk Grove Medical Supplies, Inc
• Elk Grove Natural Health
• Elk Grove Optometry a Professional Corporation
• Elk Grove Pediatrics, Inc

• Home Health Agency in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (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.