NPIMap

Organization Active NPI

Excellent Home Care Services, LLC

  • Home Health Agency
  • Brooklyn, NY
National Provider Identifier
1881708642
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EXCELLENT HOME CARE SERVICES, LLC
Practice address
91-93 South Third Street
Excellent Home Care Services, LLC
Brooklyn, NY 11249
Phone
(718) 387-1800
Fax
(718) 513-2600
NPI assigned
Aug 18, 2006
Last updated
Aug 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2017

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

Authorized official

Name
Ryvkie J Goldberger
Title
Board Member
Phone
(718) 387-1800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7001634 NY
Home Health Agency 251E00000X NY Primary

Addresses

Primary practice location

91-93 South Third Street
Excellent Home Care Services, LLC
Brooklyn, NY 11249

Mailing address

91-93 South Third Street
Excellent Home Care Services, LLC
Brooklyn, NY 11249
Phone (718) 387-1800

Other identifiers 2

IdentifierTypeStateIssuer
7001634OtherNYDOH
02624739MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021207000003 NY Part A Provider - Home Health Agency 8022926211 Practice locations: Brooklyn, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881708642. Details of each certification follow.

Home health agency certification: CCN 337424

Legal name
EXCELLENT HOME CARE SERVICES, LLC
Doing business as
EXCELLENT HOME CARE SERVICES, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 10, 2004
Last certification
Feb 27, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 10, 2004 in NY
Enrollment address
305 Berry St
Brooklyn, NY 11249-5111

Care Compare: Home health agency

Medicare Care Compare
Listed as
Excellent Home Care Services LLCCCN 337424 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Nov 10, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

12 Spencer St
Ste 3
Brooklyn, NY 11205

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
Sam Rosenbaum Individual 5% Or Greater Direct Ownership Interest Sep 12, 2018 50%
Joseph Goldberger Individual 5% Or Greater Direct Ownership Interest Jul 21, 2017 50%
Ryvkie Goldberger Individual Operational/Managerial Control Jan 28, 2007

Practitioners & affiliated clinicians

Practitioners 2

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 19

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503273600000",
    "number": "1881708642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-93 SOUTH THIRD STREET",
            "address_2": "EXCELLENT HOME CARE SERVICES, LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11249",
            "telephone_number": "718-387-1800",
            "fax_number": "718-513-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-93 SOUTH THIRD STREET",
            "address_2": "EXCELLENT HOME CARE SERVICES, LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11249",
            "telephone_number": "718-387-1800",
            "fax_number": "718-513-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2017-08-21",
        "status": "A",
        "authorized_official_last_name": "GOLDBERGER",
        "authorized_official_first_name": "RYVKIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "718-387-1800"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "7001634",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH",
            "identifier": "7001634",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02624739",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.