Active NPI
Ay Home Health Care LLC
- Home Health Agency
- Aurora, CO
National Provider Identifier
1871249888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- AY HOME HEALTH CARE LLC
- Doing business as
- AY Home Health Care LLC
- Practice address
- 3190 S Vaughn Way Ste 550
Aurora, CO 80014-3538 - Phone
- (303) 955-8096
- Fax
- (303) 953-9402
- NPI assigned
- Feb 28, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nunu Goshu, RN,BSN,MPH
- Title
- Administrator
- Phone
- (303) 955-8096
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
3190 S Vaughn Way Ste 550
Aurora, CO 80014-3538
Mailing address
16438 E Hialeah Dr
Centennial, CO 80015-4112
Phone (303) 955-8096
Other names 1
- AY Home Health Care LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230203002024 | CO | Part A Provider - Home Health Agency | 9335511153 | Practice locations: Aurora, CO |
Home health agency certification: CCN 067637
- Legal name
- AY HOME HEALTH CARE LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 20, 2023
- Last certification
- Nov 30, 2023
- Organization structure
- LLC
- Incorporated
- Feb 17, 2022 in CO
- Enrollment address
- 3190 S Vaughn Way
Ste 550
Aurora, CO 80014-3538
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Ay Home Health Care LLC
- Overall star rating
- Ownership
- -
- Certified
- Dec 20, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Ay Home Health Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Aurora, CO
- NPI 1407697444
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nunu Goshu | 5% Or Greater Direct Ownership Interest | Feb 17, 2022 | 80% |
| Corporate Officer | Feb 17, 2022 | ||
| Corporate Director | Feb 17, 2022 | ||
| W-2 Managing Employee | Feb 17, 2022 | ||
| Selamawit Alemayehu | 5% Or Greater Direct Ownership Interest | Feb 17, 2022 | 20% |
| Corporate Officer | Feb 17, 2022 | ||
| Corporate Director | Feb 17, 2022 | ||
| W-2 Managing Employee | Feb 17, 2022 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718064000000",
"number": "1871249888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16438 E HIALEAH DR",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "800154112",
"telephone_number": "303-955-8096",
"fax_number": "303-953-9402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3190 S VAUGHN WAY STE 550",
"city": "AURORA",
"state": "CO",
"postal_code": "800143538",
"telephone_number": "303-955-8096",
"fax_number": "303-953-9402"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AY HOME HEALTH CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-28",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A",
"authorized_official_last_name": "GOSHU",
"authorized_official_first_name": "NUNU",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "303-955-8096",
"authorized_official_credential": "RN,BSN,MPH"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "AY Home Health Care LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "AY Home Health Care LLC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.