Organization Active NPI

Etairos Care at Home Inc

  • Home Health Agency
  • Port St Lucie, FL
National Provider Identifier
1871782508
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA299992690 Issued in FL
Legal business name
ETAIROS CARE AT HOME INC
Doing business as
Comprehensive Home Care of Palm Beach
Practice address
1850 SW Fountainview Blvd
Port St Lucie, FL 34986-3443
Phone
(561) 588-0996
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Brett Rager
Title
VP Reimbursement
Phone
(727) 614-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA299992690 FL Primary

Addresses

Primary practice location

1850 SW Fountainview Blvd
Port St Lucie, FL 34986-3443

Mailing address

13787 Belcher Rd S Ste 220
Largo, FL 33771-4065
Phone (727) 614-8300

Other names 1

  • Comprehensive Home Care of Palm Beach Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Home Care of Palm Beach5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

6450 NW 5th Way
Ft Lauderdale, FL 33309
Phone (954) 834-2222

13787 Belcher Rd S
Ste 220
Largo, FL 33771
Phone (727) 524-2896

1850 SW Fountainview Blvd
Ste 211
Port St Lucie, FL 34986
Phone (772) 323-2133

110 Century Blvd
Ste 102
West Palm Beach, FL 33417
Phone (561) 588-0996

560 Village Blvd
Ste 335
West Palm Beach, FL 33409
Phone (561) 588-0996

2000 Palm Beach Lakes Blvd
Ste 602
West Palm Beach, FL 33409
Phone (561) 588-0996

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Polaris Management LLC Organization, Ft Lauderdale, FL LLC, Management services company, For-profit Operational/Managerial Control Jul 14, 2010
Denise Bellville Individual Contracted Managing EmployeeCorp Compliance Officer Dec 15, 2011
Garrett Bragg Individual 5% Or Greater Direct Ownership Interest Feb 21, 2003 100%
Corporate OfficerPres / Ceo Feb 21, 2003
Corporate DirectorPres /Ceo Feb 21, 2003
Ted Anderer Individual W-2 Managing EmployeeCfo Dec 4, 2017
Jamie a Plastina Individual Contracted Managing EmployeeAdministrator Aug 10, 2012
Lisa Martinolich Individual W-2 Managing EmployeeAdministrator Aug 17, 2017
Virgo Investment Group LLC Organization, Palo Alto, CA LLC, Investment firm, For-profit 5% Or Greater Security Interest Jul 14, 2010 100%

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1871782508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13787 BELCHER RD S STE 220",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337714065",
            "telephone_number": "727-614-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SW FOUNTAINVIEW BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863443",
            "telephone_number": "561-588-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETAIROS CARE AT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "RAGER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "727-614-8300"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA299992690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Home Care of Palm Beach",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Comprehensive Home Care of Palm Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.