NPIMap

Organization Active NPI

Rancho Bernardo Healthcare LLC

Doing business as Seaport Home Health

  • Home Health Agency
  • Carlsbad, CA
National Provider Identifier
1891310975
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
RANCHO BERNARDO HEALTHCARE LLC
Doing business as
Seaport Home Health
Practice address
5411 Avenida Encinas Ste 250
Carlsbad, CA 92008-4409
Phone
(858) 634-5870
Fax
(858) 634-5888
NPI assigned
Jun 15, 2020
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Lee Johnson
Title
Treasurer
Phone
(208) 401-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5411 Avenida Encinas Ste 250
Carlsbad, CA 92008-4409

Mailing address

5411 Avenida Encinas Ste 250
Carlsbad, CA 92008-4409
Phone (858) 634-5870

Other names 1

  • Seaport Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200924000013 CA Part A Provider - Home Health Agency 5496174575 Practice locations: Carlsbad, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891310975. Details of each certification follow.

Home health agency certification: CCN 059303

Legal name
RANCHO BERNARDO HEALTHCARE LLC
Doing business as
SEAPORT HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 26, 2011
Last certification
Jun 5, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Nov 19, 2019 in DE
Enrollment address
5411 Avenida Encinas
Ste 250
Carlsbad, CA 92008-4409

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Seaport Home HealthCCN 059303 · All quality measures
Ownership
Proprietary
Certified
May 26, 2011
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
05D2016656Seaport Home Health5411 Avenida Encinas, Ste 250, Carlsbad, CA 92008Certificate of waiverNov 21, 2026

National Provider Directory

National Provider Directory
Tax ID family
Rancho Bernardo Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Scripps Health

    dba Scripps Memorial Hospital La Jolla

    • General Acute Care Hospital
    • La Jolla, CA
    • NPI 1841277704

    Member Of

    NPD member

Locations

5411 Avenida Encinas
Ste 250
Carlsbad, CA 92008
Phone (858) 634-5870

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Edward Turk Individual Corporate DirectorLLC Manager Oct 1, 2020
Triumph Healthcare LLC Organization, Eagle, ID LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2020 60%
Anil Keswani Individual Corporate DirectorLLC Manager Oct 1, 2020
Timothy Johnson Individual W-2 Managing EmployeeAdministrator Apr 1, 2022
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 60%
William Bradley Individual Corporate DirectorLLC Manager Oct 1, 2020
Brent Guerisoli Individual Corporate OfficerPresident Oct 1, 2020
Corporate DirectorLLC Manager Oct 1, 2020
Lee Johnson Individual Corporate OfficerTreasurer Oct 1, 2020
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 60%
IHS Holding Company LLC Organization, San Diego, CA Holding company 5% Or Greater Indirect Ownership Interest Oct 1, 2020 40%
John J Gochnour Individual Corporate DirectorLLC Manager Oct 1, 2020
Scripps Health Organization, San Diego, CA Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2020 40%
Elliot McMillan Individual Corporate OfficerSecretary Oct 1, 2020
Scripps Home Health and Hospice Venture LLC Organization, San Diego, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2020 40%

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Scripps Health

    dba Scripps Mercy Hospital Behavioral Health Unit

    • Psychiatric Hospital Unit
    • San Diego, CA
    • NPI 1154308005

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Clinic Ambulatory Surgery Center

    • Ambulatory Surgical Clinic/Center
    • San Diego, CA
    • NPI 1245216928

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Clinic

    • Multi-Specialty Clinic/Center
    • La Jolla, CA
    • NPI 1275899072

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba ASC - Jefferson

    • Ambulatory Surgical Clinic/Center
    • Oceanside, CA
    • NPI 1417580028

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health
    • Clinical Medical Laboratory
    • La Jolla, CA
    • NPI 1427034990

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Mercy Hospital

    • General Acute Care Hospital
    • San Diego, CA
    • NPI 1659359446

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Memorial Hospital Encinitas

    • General Acute Care Hospital
    • Encinitas, CA
    • NPI 1700829199

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Clinic Medical Laboratories

    • Anatomic Pathology & Clinical Pathology Physician
    • La Jolla, CA
    • NPI 1720755275

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Green Hospital

    • General Acute Care Hospital
    • La Jolla, CA
    • NPI 1841233780

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health

    dba Scripps Memorial Hospital La Jolla

    • General Acute Care Hospital
    • La Jolla, CA
    • NPI 1841277704

    5% Or Greater Indirect Ownership Interest

    CMS ownership
  • Scripps Health
    • Ambulatory Surgical Clinic/Center
    • La Jolla, CA
    • NPI 1972054534

    5% Or Greater Indirect Ownership Interest

    CMS ownership

Facilities with the same owner 143

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 143

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2020 Change of OwnershipThis provider was the buyer Seaport Home HealthCCN 059303, CA, NPI 1265837405

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1891310975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 AVENIDA ENCINAS STE 250",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084409",
            "telephone_number": "858-634-5870",
            "fax_number": "858-634-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 AVENIDA ENCINAS STE 250",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084409",
            "telephone_number": "858-634-5870",
            "fax_number": "858-634-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO BERNARDO HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaport Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.