United Odd Fellow and Rebekah Home

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

7000611 Issued in NY

Legal business name

UNITED ODD FELLOW AND REBEKAH HOME

Practice address

1040 Havemeyer Ave
Bronx, NY 10462-5382

Phone

(718) 863-6200

Fax

(914) 530-2177

NPI assigned

Dec 21, 2007

Last updated

Apr 10, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

REBEKAH REHAB & EXTENDED CAREAs reported in NPPES

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

Authorized official

Name

Mr. Michael Felberg

Title

Ceo

Phone

(718) 863-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rebekah CHHA Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841474145. Details of each certification follow.

• CCN 337430 Home health agency · Active · Details

Home health agency certification: CCN 337430

Legal name

UNITED ODD FELLOW AND REBEKAH HOME

Doing business as

REBEKAH CERTIFIED HOME HEALTH AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 4, 2007

Last certification

Mar 15, 2019

Ownership / control type

Non-Profit

Organization structure

CorporationNon-profit

Incorporated

Aug 9, 1965 in NY

Enrollment address

1040 Havemeyer Ave
Bronx, NY 10462-5382
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• United Odd Fellow and Rebekah Home

  dba Rebekah Rehab

  • Skilled Nursing Facility
  • Bronx, NY
  • NPI 1801898192

  9537071345

  Same PAC ID

Listed as

Rebekah Certified Home Health AgencyCCN 337430 · All quality measures

Overall star rating

2 of 5

Ownership

Non-Profit

Certified

Oct 4, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy

Tax ID family

United Odd Fellow Rebekah2 organizations share this tax ID, including this one

Part of

United Odd Fellow Rebekah

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• United Odd Fellow and Rebekah Home

  dba Rebekah Rehab

  • Skilled Nursing Facility
  • Bronx, NY
  • NPI 1801898192
  NPD tax ID

Locations

All disclosed owners & managing parties 9

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jeffrey Charles Gold, MD

  • Internal Medicine Physician
  • Chappaqua, NY
  • NPI 1780890574

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 3

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

• Venkata Harini Chintaluri

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1215282512

  Home health agency

  Care Compare affiliation
• Thelma C Monterroso, NP-C, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1265786545

  Home health agency

  Care Compare affiliation
• Alison Uccello, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1821259268

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1841474145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 HAVEMEYER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625382",
            "telephone_number": "718-863-6200",
            "fax_number": "914-530-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HAVEMEYER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625382",
            "telephone_number": "718-863-6200",
            "fax_number": "914-530-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED ODD FELLOW AND REBEKAH HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REBEKAH REHAB & EXTENDED CARE",
        "enumeration_date": "2007-12-21",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "FELBERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-863-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "7000611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02935046",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebekah CHHA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• United States Marine Corps
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• Home Health Agency in Bronx, NY
• Providers in Bronx, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.