Medstar Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEDSTAR HOME HEALTH, INC.

Practice address

21221 S Western Ave Ste 140 Room 1608
Torrance, CA 90501-2972

Phone

(818) 967-5544

Fax

(818) 967-5445

NPI assigned

Jul 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Erickson Cruz Bautista, DNP MSN-AGNP

Title

Secretary

Phone

(818) 967-5544

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 753171

Legal name

MEDSTAR HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 6, 2022

Last certification

Mar 17, 2022

Organization structure

CorporationProprietary

Enrollment address

21221 S. Western Ave
Ste 140 Room 1608
Torrance, CA 90501-2970

Listed as

Medstar Home Health, IncCCN 753171

Ownership

-

Certified

Apr 6, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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

Affiliated clinicians 1

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

• Anousheh Ashouri, M.D.

  • Hospitalist Physician
  • Riverside, CA
  • NPI 1336305036

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1902392095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21221 S WESTERN AVE STE 140 ROOM 1608",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012972",
            "telephone_number": "818-967-5544",
            "fax_number": "818-967-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21221 S WESTERN AVE STE 140 ROOM 1608",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012972",
            "telephone_number": "818-967-5544",
            "fax_number": "818-967-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "ERICKSON",
        "authorized_official_middle_name": "CRUZ",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "818-967-5544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP MSN-AGNP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan B Medlicott, RNFA
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• Nichelle Megowan
• Filmon Mehanzel, MD
• Sheherbano Mehdi, M.D

• Home Health Agency in Torrance, CA
• Providers in Torrance, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.