NPIMap

Organization Active NPI

Shant Home Health Care, Inc.

  • Home Health Agency
  • Van Nuys, CA
National Provider Identifier
1801831383
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
550000453 Issued in CA
Legal business name
SHANT HOME HEALTH CARE, INC.
Practice address
6033 Woodman Ave
Van Nuys, CA 91401-2925
Phone
(818) 782-9123
Fax
(818) 780-1175
NPI assigned
Jun 18, 2006
Last updated
Feb 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Ms. Mariam Tutunjian, RN
Title
Ceo
Phone
(818) 782-9123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 550000453 CA Primary

Addresses

Primary practice location

6033 Woodman Ave
Van Nuys, CA 91401-2925

Mailing address

6033 Woodman Ave
Van Nuys, CA 91401-2925
Phone (818) 782-9123

Other identifiers 1

IdentifierTypeStateIssuer
HHA08399FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070216000443 CA Part A Provider - Home Health Agency 6507968831 Practice locations: Van Nuys, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801831383. Details of each certification follow.

Home health agency certification: CCN 058399

Legal name
SHANT HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 21, 2007
Last certification
Apr 11, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 15, 2006 in CA
Enrollment address
6033 Woodman Ave
Van Nuys, CA 91401-2925

Care Compare: Home health agency

Medicare Care Compare
Listed as
Shant Home Health CareCCN 058399 · All quality measures
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Sep 21, 2007
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
05D1064787Shant Home Health Care, Inc6033 Woodman Ave, Van Nuys, CA 91401Certificate of waiverFeb 12, 2027

National Provider Directory

National Provider Directory

Locations

6033 Woodman Ave
Van Nuys, CA 91401
Phone (818) 782-9123

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Eli E Hendel Individual Corporate DirectorMedical Director Feb 1, 2013
Karine Mkrtumyan Individual 5% Or Greater Direct Ownership InterestCfo Jun 30, 2019 50%
Corporate Officer Jul 12, 2019 50%
W-2 Managing EmployeeDopcs/Administrator Jun 29, 2022 50%
Operational/Managerial Control Jun 1, 2022 100%
Rafael Mkrtchyan Individual 5% Or Greater Direct Ownership Interest Jun 30, 2019 50%
Corporate OfficerCeo Jun 30, 2019 50%
W-2 Managing EmployeeCeo Jun 30, 2019 50%

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1801831383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 WOODMAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012925",
            "telephone_number": "818-782-9123",
            "fax_number": "818-780-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 WOODMAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012925",
            "telephone_number": "818-782-9123",
            "fax_number": "818-780-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANT HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "TUTUNJIAN",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-782-9123",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550000453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08399F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.