Organization Active NPI

Ay Home Health Care LLC

  • Home Health Agency
  • Aurora, CO
National Provider Identifier
1871249888
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Jun 11, 2024

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 LLCCCN 067637 · All quality measures
Overall star rating
3.5 of 5
Ownership
-
Certified
Dec 20, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ay Home Health Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

NameRoleSinceShare
Nunu Goshu Individual 5% Or Greater Direct Ownership Interest Feb 17, 2022 80%
Corporate OfficerDon; Treasurer; Board Member Feb 17, 2022
Corporate DirectorDon; Treasurer; Board Member Feb 17, 2022
W-2 Managing EmployeeDon; Treasurer; Board Member Feb 17, 2022
Selamawit Alemayehu Individual 5% Or Greater Direct Ownership Interest Feb 17, 2022 20%
Corporate OfficerAdministrator; Board Member Feb 17, 2022
Corporate DirectorAdministrator/Board Member Feb 17, 2022
W-2 Managing EmployeeAdministrator; Board Member 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

Verify at the official NPI Registry.