NPIMap

Organization Active NPI

Matrix Health Promotion

Doing business as Matrix Home Health

  • Home Health Agency
  • Encino, CA
National Provider Identifier
1831328400
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MATRIX HEALTH PROMOTION
Doing business as
Matrix Home Health
Practice address
17141 Ventura Blvd Ste 204
Encino, CA 91316-4036
Phone
(818) 343-7800
Fax
(818) 343-7808
NPI assigned
Jul 4, 2009
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Mahnaz Hakami
Title
Ceo
Phone
(818) 343-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

17141 Ventura Blvd Ste 204
Encino, CA 91316-4036

Mailing address

17141 Ventura Blvd Ste 204
Encino, CA 91316-4036
Phone (818) 343-7800

Other names 1

  • Matrix Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090903000614 CA Part A Provider - Home Health Agency 4688729213 Practice locations: Encino, CA
O20210511002363 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4688729213 Practice locations: Tarzana, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831328400. Details of each certification follow.

Home health agency certification: CCN 059266

Legal name
MATRIX HEALTH PROMOTION
Doing business as
MATRIX HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 27, 2011
Last certification
Sep 13, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 30, 2008 in CA
Enrollment address
17141 Ventura Blvd
Ste 204
Encino, CA 91316-4036

Care Compare: Home health agency

Medicare Care Compare
Listed as
Matrix Home HealthCCN 059266 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jan 27, 2011
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
05D2001479Matrix Health Promotion17141 Ventura Blvd Suite 204, Encino, CA 91316Certificate of waiverDec 20, 2027

National Provider Directory

National Provider Directory

Locations

19562 Ventura Blvd
Tarzana, CA 91356

19562 Ventura Blvd
Ste 209
Tarzana, CA 91356
Phone (818) 343-7800

19562 Ventura Blvd
Ste 225
Tarzana, CA 91356

Ownership & related parties

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.

NameRoleSinceShare
Mahnaz Hakami Individual 5% Or Greater Direct Ownership InterestPresident/Ceo/Cfo Aug 14, 2009 100%
Corporate OfficerPresident/Ceo/Cfo Aug 14, 2009 100%
Corporate DirectorAdministrator Aug 14, 2009 100%
W-2 Managing EmployeePresident/Ceo/Cfo Aug 14, 2009 100%
Operational/Managerial ControlAdministrator Mar 3, 2011 100%

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": "1246665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1831328400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17141 VENTURA BLVD STE 204",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164036",
            "telephone_number": "818-343-7800",
            "fax_number": "818-343-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17141 VENTURA BLVD STE 204",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164036",
            "telephone_number": "818-343-7800",
            "fax_number": "818-343-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATRIX HEALTH PROMOTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-04",
        "last_updated": "2023-04-11",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "HAKAMI",
        "authorized_official_first_name": "MAHNAZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-343-7800"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matrix Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.