Mt Carmel Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MT CARMEL HOME HEALTH LLC

Practice address

6268 Spring Mountain Rd Ste 110B
Las Vegas, NV 89146-8874

Phone

(702) 954-5670

Fax

(702) 954-5680

NPI assigned

Jan 26, 2022

Last updated

Jan 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Perla Tagalicud Bautista

Title

Administrator

Phone

(702) 954-5670

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801548284. Details of each certification follow.

• CCN 297352 Home health agency · Active · Details

Home health agency certification: CCN 297352

Legal name

MT CARMEL HOME HEALTH LLC

Doing business as

N/A

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 11, 2024

Last certification

Apr 4, 2024

Organization structure

LLCProprietary

Incorporated

Nov 8, 2021 in NV

Enrollment address

6268 Spring Mountain Rd
Ste 110B
Las Vegas, NV 89146-8874

Listed as

Mt Carmel Home Health LLCCCN 297352 · All quality measures

Ownership

-

Certified

Apr 11, 2024

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 2

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

• Sharon Evonne Ruch, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1619174307

  Home health agency

  Care Compare affiliation
• Carlos F Inocencio, MD

  • General Practice Physician
  • Dinuba, CA
  • NPI 1558319293

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1801548284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 SPRING MOUNTAIN RD STE 110B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891468874",
            "telephone_number": "702-954-5670",
            "fax_number": "702-954-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 SPRING MOUNTAIN RD STE 110B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891468874",
            "telephone_number": "702-954-5670",
            "fax_number": "702-954-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT CARMEL HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "PERLA",
        "authorized_official_middle_name": "TAGALICUD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-954-5670"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA SECRETARY OF STATE",
            "identifier": "NV20212274841",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lan Lan Mu
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• Morgan Mucciarone Vaden, LMSW

• Home Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.