Organization Active NPI

Platinum Home Health Care, Inc.

  • Home Health Agency
  • Orland Park, IL
National Provider Identifier
1871538066
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IL10104096 Issued in IL
Legal business name
PLATINUM HOME HEALTH CARE, INC.
Practice address
16634 107TH St
Orland Park, IL 60467-8898
Phone
(708) 995-7758
Fax
(708) 995-7986
NPI assigned
Jun 19, 2006
Last updated
Nov 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Authorized official

Name
Mr. Estelito Espano Jr.
Title
President
Phone
(708) 995-7758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IL10104096 IL Primary

Addresses

Primary practice location

16634 107TH St
Orland Park, IL 60467-8898

Mailing address

16634 107TH St
Orland Park, IL 60467-8898
Phone (708) 995-7758

Other identifiers 1

IdentifierTypeStateIssuer
IL1010409OtherILILLINOIS LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050926001209 IL Part A Provider - Home Health Agency 7214961424 Practice locations: Orland Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871538066. Details of each certification follow.

Home health agency certification: CCN 147864

Legal name
PLATINUM HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 11, 2006
Last certification
Mar 13, 2020
Ownership / control type
Proprietary
Organization structure
OtherProprietary
Incorporated
Aug 17, 2004 in IL
Enrollment address
16634 107TH St
Orland Park, IL 60467-8898
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Platinum Home Health Care, IncCCN 147864 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Apr 11, 2006
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
14D1041697Platinum Home Health Care Inc16634 107TH St, Orland Park, IL 60467Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory

Locations

4903 W 95th St
Oak Lawn, IL 60453
Phone (708) 229-9338

16634 107th St
Orland Park, IL 60467
Phone (708) 995-7758

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Estelito Espano Individual 5% Or Greater Direct Ownership Interest Aug 4, 2004 50%
Corporate OfficerPresident/Ceo Aug 4, 2004 50%
Corporate DirectorBoard Member Aug 4, 2004 50%
W-2 Managing EmployeeAdministrator Aug 4, 2004 50%
Operational/Managerial ControlAdministrator Aug 4, 2004 50%
Marsha Espano Individual 5% Or Greater Direct Ownership Interest Aug 4, 2004 10%
Corporate OfficerVice President Aug 4, 2004 10%
Corporate DirectorBoard Member Aug 4, 2004 10%
W-2 Managing EmployeeAgency Supervisor Aug 5, 2004 10%
Operational/Managerial ControlAgency Supervisor Aug 4, 2004 10%
Vilma Cristobal-Mendoza Individual 5% Or Greater Direct Ownership Interest Aug 4, 2004 40%
Corporate OfficerSecretary Aug 4, 2004 40%
Corporate DirectorBoard Member Aug 4, 2004 40%
W-2 Managing EmployeeNursing Supervisor Aug 4, 2004 40%
Operational/Managerial ControlNursing Supervisor Aug 4, 2004 40%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1871538066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16634 107TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678898",
            "telephone_number": "708-995-7758",
            "fax_number": "708-995-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16634 107TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678898",
            "telephone_number": "708-995-7758",
            "fax_number": "708-995-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "ESPANO",
        "authorized_official_first_name": "ESTELITO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-995-7758",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "IL10104096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "IL1010409",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.