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Organization Active NPI

Holy Name Medical Center Inc

Doing business as Holy Name Hospital Homecare

  • Home Health Agency
  • Teaneck, NJ
National Provider Identifier
1780760405
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
70205 Issued in NJ
Legal business name
HOLY NAME MEDICAL CENTER INC
Doing business as
Holy Name Hospital Homecare
Practice address
718 Teaneck Road
Teaneck, NJ 07666-4249
Phone
(201) 833-3000
Fax
(201) 530-7900
NPI assigned
Oct 27, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HOLY NAME MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Doug Zehner
Title
Cfo
Phone
(201) 833-7016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 70205 NJ Primary

Addresses

Primary practice location

718 Teaneck Road
Teaneck, NJ 07666-4249

Mailing address

718 Teaneck Road
Teaneck, NJ 07666-4249
Phone (201) 833-3000

Other identifiers 1

IdentifierTypeStateIssuer
4146603MedicaidNJ

Other names 1

  • Holy Name Hospital Homecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120823000527 NJ Part A Provider - Home Health Agency 3971665183 Practice locations: Teaneck, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780760405. Details of each certification follow.

Home health agency certification: CCN 317077

Legal name
HOLY NAME MEDICAL CENTER INC
Doing business as
HOLY NAME HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 30, 1985
Last certification
Sep 26, 2019
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Jun 24, 1958 in NJ
Enrollment address
718 Teaneck Rd
Teaneck, NJ 07666-4245

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Holy Name Home CareCCN 317077 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Dec 30, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Holy Name Medical Center9 organizations share this tax ID, including this one
Part of
Holy Name Medical Center

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Michele Musacchio-Acito Individual Corporate Officer Apr 30, 2024
W-2 Managing Employee Apr 30, 2024
Santo Gencarelli Individual Corporate Officer Aug 26, 2025
W-2 Managing EmployeeAd; Aug 26, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1780760405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 TEANECK ROAD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664249",
            "telephone_number": "201-833-3000",
            "fax_number": "201-530-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK ROAD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664249",
            "telephone_number": "201-833-3000",
            "fax_number": "201-530-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY NAME MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOLY NAME MEDICAL CENTER INC",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "ZEHNER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "201-833-7016"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NJ",
            "license": "70205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4146603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Name Hospital Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.