NPIMap

Organization Active NPI

Advanced Medical Home Care LLC

  • Home Health Agency
  • Little Canada, MN
National Provider Identifier
1790121291
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
H29186 Issued in MN
Legal business name
ADVANCED MEDICAL HOME CARE LLC
Practice address
206 Little Canada Rd E
Little Canada, MN 55117-1332
Phone
(612) 267-6154
Fax
(855) 316-0733
NPI assigned
May 11, 2013
Last updated
Jun 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Mike Auge, PT
Title
Ceo
Phone
(612) 267-6154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X H29186 MN Primary

Addresses

Primary practice location

206 Little Canada Rd E
Little Canada, MN 55117-1332

Mailing address

206 Little Canada Rd E
Little Canada, MN 55117-1332
Phone (612) 267-6154

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130529000240 MN Part A Provider - Home Health Agency 3375781610 Practice locations: Saint Paul, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790121291. Details of each certification follow.

Home health agency certification: CCN 248137

Legal name
ADVANCED MEDICAL HOME CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 4, 2014
Last certification
Dec 5, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 13, 2013 in MN
Enrollment address
206 Little Canada Rd E
Saint Paul, MN 55117-1332
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advanced Medical Home Care, LLCCCN 248137 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Mar 4, 2014
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
24D2063259Advanced Medical Home Care LLC206 Little Canada Road E, Little Canada, MN 55117Certificate of waiverJul 30, 2027

National Provider Directory

National Provider Directory

Locations

206 Little Canada Rd E
Saint Paul, MN 55117
Phone (612) 267-6154

2074 County Road E E
White Bear Lake, MN 55110
Phone (612) 267-6154

2555 County Road E E
Ste 101
White Bear Lake, MN 55110
Phone (612) 267-6154

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
Michael P Auge Individual 5% Or Greater Direct Ownership InterestOwner Aug 20, 2011 95%
W-2 Managing EmployeeOwner Aug 20, 2011 95%
Lauren V Auge Individual 5% Or Greater Direct Ownership InterestOwner Aug 20, 2011 5%
W-2 Managing EmployeeOwner Aug 20, 2011 5%

Practitioners & affiliated clinicians

Practitioners 1

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1368230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1790121291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 LITTLE CANADA RD E",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171332",
            "telephone_number": "612-267-6154",
            "fax_number": "651-762-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 LITTLE CANADA RD E",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171332",
            "telephone_number": "612-267-6154",
            "fax_number": "855-316-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "AUGE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-267-6154",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "H29186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Canada, MN

Sources for this page

Verify at the official NPI Registry.