NPIMap

Organization Active NPI

Pinellas 1 Home Health Care Corp

  • Home Health Agency
  • Clearwater, FL
National Provider Identifier
1861803850
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PINELLAS 1 HOME HEALTH CARE CORP
Practice address
4707 140TH Avenue North Ste 106a
Clearwater, FL 33762
Phone
(727) 532-2111
Fax
(727) 532-2333
NPI assigned
May 13, 2014
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Scott HaefeleNPI 1144493776
Title
President
Phone
(727) 422-1675

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4707 140TH Avenue North Ste 106a
Clearwater, FL 33762

Mailing address

4707 140TH Avenue North Ste 106a
Clearwater, FL 33762
Phone (727) 532-2111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141029002551 FL Part A Provider - Home Health Agency 4789805029 Practice locations: Clearwater, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861803850. Details of each certification follow.

Home health agency certification: CCN 683182

Legal name
PINELLAS 1 HOME HEALTH CARE CORP
Doing business as
FIRST SENIOR HOME HEALTH CLEARWATER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 5, 2015
Last certification
Jun 7, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
4707 140TH Ave
Ste 106 a
Clearwater, FL 33762-3834

Care Compare: Home health agency

Medicare Care Compare
Listed as
Pinellas 1 Home Health Care CorpCCN 683182 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
May 5, 2015
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
10D2079307Pinellas 1 Home Health Care Corp4707 140TH Ave N Ste 106a, Clearwater, FL 33762Certificate of waiverJun 12, 2028

National Provider Directory

National Provider Directory

Locations

4707 140th Ave N
Ste 106
Clearwater, FL 33762
Phone (727) 532-2111

4707 140th Ave N
Ste 106A
Clearwater, FL 33762
Phone (727) 532-2111

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Sheldon Ramkissoon Individual 5% Or Greater Indirect Ownership Interest Nov 18, 2024 50%
Corporate OfficerPresident Nov 18, 2024
Corporate Director Nov 18, 2024
W-2 Managing Employee Nov 18, 2024
Tomas a Lozano Individual 5% Or Greater Indirect Ownership Interest Nov 18, 2024 50%
Corporate OfficerVice President Nov 18, 2024
Corporate Director Nov 18, 2024
W-2 Managing Employee Nov 18, 2024
SSS Area 5, LLC. Organization, Lutz, FL Holding company 5% Or Greater Direct Ownership Interest Feb 17, 2025 100%
Operational/Managerial Control Nov 18, 2024 100%
Scott Haefele Individual Corporate OfficerOfficer Jul 2, 2019 100%
Corporate DirectorOfficer Jul 2, 2019 100%
W-2 Managing EmployeeOfficer Jul 2, 2019 100%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1861803850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 140TH AVENUE NORTH STE 106A",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33762",
            "telephone_number": "727-532-2111",
            "fax_number": "727-532-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 140TH AVENUE NORTH STE 106A",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "33762",
            "telephone_number": "727-532-2111",
            "fax_number": "727-532-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINELLAS 1 HOME HEALTH CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "HAEFELE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-422-1675"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.