Mirage Healthcare Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MIRAGE HEALTHCARE SERVICES INC

Practice address

2825 Wilcrest Dr Ste 518
Houston, TX 77042-6041

Phone

(713) 867-7970

Fax

(713) 867-7970

NPI assigned

Jun 26, 2009

Last updated

Mar 24, 2025By 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

Evaristus I Ajaero

Title

Administrator

Phone

(713) 867-7970

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831327014. Details of each certification follow.

• CCN 747574 Home health agency · Active · Details

Home health agency certification: CCN 747574

Legal name

MIRAGE HEALTHCARE SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 9, 2011

Last certification

Jan 8, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jul 1, 2009 in TX

Enrollment address

2825 Wilcrest Dr
Ste 518
Houston, TX 77042-6041

Listed as

Mirage Healthcare Services IncCCN 747574 · All quality measures

Ownership

Proprietary

Certified

Jun 9, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1831327014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 WILCREST DR STE 518",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770426041",
            "telephone_number": "713-867-7970",
            "fax_number": "713-867-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 WILCREST DR STE 518",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770426041",
            "telephone_number": "713-867-7970",
            "fax_number": "713-867-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-26",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "AJAERO",
        "authorized_official_first_name": "EVARISTUS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "713-867-7970"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.