Organization Active NPI

Above Care Home Health, Inc

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1881139210
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ABOVE CARE HOME HEALTH, INC
Practice address
201 N Brand Blvd Unit 200
Glendale, CA 91203-3590
Phone
(323) 533-6413
Fax
(323) 723-3967
NPI assigned
Dec 20, 2016
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Ronaldo San Jose, LACNPI 1649608621
Title
Ceo, Admin
Phone
(323) 533-6413

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

201 N Brand Blvd Unit 200
Glendale, CA 91203-3590

Mailing address

201 N Brand Blvd Ste 200
Glendale, CA 91203-2609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181226000561 CA Part A Provider - Home Health Agency 6608111489 Practice locations: Glendale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881139210. Details of each certification follow.

Home health agency certification: CCN 559180

Legal name
ABOVE CARE HOME HEALTH INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 28, 2019
Last certification
Dec 28, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 5, 2017 in CA
Enrollment address
201 N Brand Blvd
Unit 200
Glendale, CA 91203-3590
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Above Care Home Health, IncCCN 559180 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Dec 28, 2019
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
05D2168402Above Care Home Health201 North Brand Boulevard Suite 200, Glendale, CA 91203Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory

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
Devron Lindsey Individual 5% Or Greater Direct Ownership Interest Mar 1, 2024 25%
Corporate OfficerSecretary Jan 5, 2017 25%
W-2 Managing EmployeeSecretary Jan 5, 2017
Ronaldo San Jose Individual 5% Or Greater Direct Ownership Interest Mar 1, 2024 40%
Corporate OfficerCeo Jan 5, 2017 40%
Corporate DirectorCeo Jan 5, 2017 32.5%
W-2 Managing Employee Jan 5, 2017 100%
Lilybeth Flores Individual 5% Or Greater Direct Ownership Interest Mar 1, 2024 35%
Corporate OfficerCoo Jan 5, 2017 35%
W-2 Managing Employee Jan 5, 2017

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 1

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": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1881139210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N BRAND BLVD STE 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BRAND BLVD UNIT 200",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033590",
            "telephone_number": "323-533-6413",
            "fax_number": "323-723-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABOVE CARE HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-20",
        "last_updated": "2023-09-06",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "SAN JOSE",
        "authorized_official_first_name": "RONALDO",
        "authorized_official_title_or_position": "CEO, ADMIN",
        "authorized_official_telephone_number": "323-533-6413",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.