Nueva Vida de la Salud Home Care Corp
Organization Active NPI Home Health Agency · Bayamon, PR
NPI 1902167703 · NPPES record last updated Feb 26, 2021
Key facts
- NPI
- 1902167703
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- NUEVA VIDA DE LA SALUD HOME CARE CORP
- Practice address
- Carr # 2 - KM 15.5, Suite 7
Hato Tejas
Bayamon, PR 00959-6107 - Phone
- (787) 915-5748
- Fax
- (787) 915-5814
- NPI assigned
- Jun 7, 2012
- Organization subpart
- No
Authorized official
- Name
- Linda J. Mendez
- Title
- Coo
- Phone
- (787) 620-2900
Owners & managing parties with NPI records 2
Member of 1
Facilities with the same owner 9
Affiliated clinicians 2
-
Marysol Vicente, MD
Medicare Care Compare: Home health agency
- Listed as
- Nueva Vida de la Salud Home Care Corp
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Dec 13, 2013
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Home health agency certification: CCN 407035
- Legal name
- NUEVA VIDA DE LA SALUD HOME CARE, CORP.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 13, 2013
- Last certification
- Dec 28, 2016
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Jun 5, 2012 in PR
- Enrollment address
- Plaza Bayamon Carr # 2 KM 15.5
Suite 6 & 7 Hato Tejas
Bayamon, PR 00959-6107
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Ihcs/CMS Parent LLC |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 100% |
| Donald K Klink |
Corporate Officer | Aug 28, 2023 | |
| Ajani Pidikiti Nimmagadda |
Corporate Officer |
Oct 7, 2024 | |
| Clinical Medical Services, Inc. |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 100% |
| Ihcs/CMS Holdings LLC |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 100% |
| Nautic Partners VIII LP |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 42.2% |
| CMS Home Care LLC |
5% Or Greater Direct Ownership Interest | Jul 16, 2013 | 100% |
| Christopher Bradbury |
Corporate Officer |
Aug 26, 2022 | |
| Raul Rodriguez-Alvarez |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 11.6% |
| Nautic Partners VIII a LP |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 16.4% |
| CMS Purchaser LLC |
5% Or Greater Indirect Ownership Interest | Sep 14, 2018 | 100% |
| Linda J Mendez |
Corporate Officer |
Sep 14, 2018 | |
| Corporate Director |
Jul 16, 2013 | ||
| Operational/Managerial Control | Jan 29, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130206000177 | PR | Part a Provider - Home Health Agency | 6406000140 | Practice locations: Bayamon, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
Carr # 2 - KM 15.5, Suite 7
Hato Tejas
Bayamon, PR 00959-6107
Mailing address
PO Box 3569
Carolina, PR 00984-3569
Phone (787) 915-5748
Other providers in Bayamon, PR
- Nova Heart, LLC
- Nova Infusion & Compounding Pharmacy
- Novavida Health Clinic LLC
- Jose E Novoa
- Nucmed, CSP
- Jose R Nunez Maceira
- Juan J Nunez Orta
- Geisy Claritza Nunez Pimentel
- Judit Priscila Nunez Rodriguez
- Jose Francisco Nunez-Morales
All providers in Bayamon, PR · Home Health Agency in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.