American Home Health, Inc
Organization Active NPI Home Health Agency · West Hartford, CT
NPI 1801059134 · NPPES record last updated Feb 26, 2010
Key facts
- NPI
- 1801059134
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 0033 (CT)
- Legal business name
- AMERICAN HOME HEALTH, INC
- Practice address
- 485 New Park Ave
Suite O3
West Hartford, CT 06110-1333 - Phone
- (860) 838-2858
- Fax
- (860) 760-6233
- NPI assigned
- Jul 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Igor M Ofengeym
- Title
- Owner
- Phone
- (203) 996-5740
Affiliated clinicians 1
-
Maryanna Polukhin, M.D.
Medicare Care Compare: Home health agency
- Listed as
- American Home Health, Inc
- Overall star rating
- ★★☆☆☆ 2 of 5
- Ownership
- Proprietary
- Certified
- Dec 1, 2010
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 07D2006788 | American Home Health Inc | Certificate of waiver | Apr 28, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Home health agency certification: CCN 077250
- Legal name
- AMERICAN HOME HEALTH, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 1, 2010
- Last certification
- Jul 25, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 21, 2007 in CT
- Enrollment address
- 567 New Park Ave
West Hartford, CT 06110-1348
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Igor Ofengeym |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 24% |
| General Partnership Interest | Jun 12, 2008 | 24% | |
| Corporate Officer | Jun 12, 2008 | 24% | |
| Akim Gold |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 12.5% |
| General Partnership Interest | Jun 12, 2008 | 12.5% | |
| Jane Gold |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 12.5% |
| General Partnership Interest | Jun 12, 2008 | 12.5% | |
| Boris Klimenko |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 12.5% |
| General Partnership Interest | Jun 12, 2008 | 12.5% | |
| Aida Ofengeym |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 26% |
| General Partnership Interest | Jun 12, 2008 | 26% | |
| Corporate Officer | Jun 12, 2008 | 26% | |
| Margarita Bursak |
5% Or Greater Direct Ownership Interest | Jun 12, 2008 | 12.5% |
| General Partnership Interest | Jun 12, 2008 | 12.5% | |
| Marina Ofengeym |
Corporate Officer | Jun 12, 2008 | |
| W-2 Managing Employee |
Jun 12, 2008 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080819000881 | CT | Part a Provider - Home Health Agency | 7113092594 | Practice locations: West Hartford, CT |
National Provider Directory
Locations
485 New Park Ave
Ste O3
West Hartford, CT 06110
Phone (860) 838-2858
567 New Park Ave
West Hartford, CT 06110
Phone (860) 838-2858
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 0033 | CT | Yes |
Addresses
Primary practice location
485 New Park Ave
Suite O3
West Hartford, CT 06110-1333
Mailing address
485 New Park Ave
Suite O3
West Hartford, CT 06110-1333
Phone (860) 838-2858
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2010. 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.