Mountain Crest Home Health, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOUNTAIN CREST HOME HEALTH, LLC

Practice address

10501 W Gowan Rd Ste 170
Las Vegas, NV 89129-6603

Phone

(702) 785-0128

Fax

(702) 785-0127

NPI assigned

Oct 27, 2009

Last updated

Jun 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nona Bautista

Title

Ceo

Phone

(702) 785-0128

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902132954. Details of each certification follow.

• CCN 297187 Home health agency · Active · Details

Home health agency certification: CCN 297187

Legal name

MOUNTAIN CREST HOME HEALTH, LLC

Doing business as

MOUNTAIN CREST HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 26, 2010

Last certification

Jan 22, 2020

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

2595 Montessouri St
Las Vegas, NV 89117-3009

Listed as

Mountain Crest Home HealthCCN 297187 · All quality measures

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Aug 26, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

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

Affiliated clinicians 2

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

• Bernard K. Addo-Quaye, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1922009208

  Home health agency

  Care Compare affiliation
• Naima Zaheer, MD

  • Infectious Disease Physician
  • Las Vegas, NV
  • NPI 1447412192

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1902132954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 W GOWAN RD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296603",
            "telephone_number": "702-785-0128",
            "fax_number": "702-785-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 W GOWAN RD STE 170",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296603",
            "telephone_number": "702-785-0128",
            "fax_number": "702-785-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN CREST HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "NONA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-785-0128"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mountain Oasis Counseling, LLC
• Mountain Peaks Surgery Center

• Home Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.