NPIMap

Organization Active NPI

Professional Healthcare Resources, Inc.

Doing business as Professional Healthcare

  • Home Health Agency
  • Annandale, VA
National Provider Identifier
1912953548
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
497502 Issued in VA
Legal business name
PROFESSIONAL HEALTHCARE RESOURCES, INC.
Doing business as
Professional Healthcare
Practice address
7619 Little River Tpke
Ste. 600
Annandale, VA 22003-2625
Phone
(703) 752-8700
Fax
(703) 752-8779
NPI assigned
May 25, 2006
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Eleni Trivizas
Title
Director of Revenue
Phone
(703) 752-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 497502 VA Primary

Addresses

Primary practice location

7619 Little River Tpke
Ste. 600
Annandale, VA 22003-2625

Mailing address

7619 Little River Tpke
Ste. 600
Annandale, VA 22003-2625
Phone (703) 752-8700

Other identifiers 1

IdentifierTypeStateIssuer
4973551MedicaidVA

Other names 1

  • Professional Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000376 VA Part A Provider - Home Health Agency 4284541079 Practice locations: Annandale, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912953548. Details of each certification follow.

Home health agency certification: CCN 497502

Legal name
PROFESSIONAL HEALTHCARE RESOURCES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 6, 1995
Last certification
Oct 3, 2008
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 21, 1994 in VA
Enrollment address
7619 Little River Tpke
Ste 600
Annandale, VA 22003-2628

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
Professional Healthcare Resources, IncCCN 497502 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Sep 6, 1995
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
Tax ID family
Professional Healthcare Resources Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7619 Little River Tpke
Ste 600
Annandale, VA 22003
Phone (703) 379-9012

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Professional Healthcare Resources, Inc. Organization, Annandale, VA Corporation Operational/Managerial Control Apr 21, 2000
De Cesare GST Non-Grantor Gift Trust Organization, Annandale, VA Created for acquisition 5% Or Greater Indirect Ownership Interest Feb 29, 2008 52.4%
Professional Healthcare Management, Inc Organization, Annandale, VA Management services company Operational/Managerial Control Jan 1, 2008
Ronald Decesare Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2004 45%
PHR Holdings, Inc. Organization, Annandale, VA Holding company 5% Or Greater Direct Ownership Interest Jan 1, 2004 100%
Mary Vrtis Individual W-2 Managing EmployeeAdministrator Sep 27, 2019
Operational/Managerial ControlAdministrator Sep 27, 2019
Eileen Decesare Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2004 2.6%
Corporate OfficerPresident and Board Chair Jan 21, 1994
Corporate DirectorPresident and Board Chair Jan 12, 2005

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
PHR of Maryland, Inc.Lanham, MD, CCN 217120A Home health agency Operational/Managerial Control May 2, 2003
Professional Healthcare Resources of Washington DC, Inc.Washington, DC, CCN 097049 Home health agency Operational/Managerial Control Apr 21, 2000
Professional Healthcare Resources of Maryland IncKensington, MD, CCN 217154 Home health agency Operational/Managerial Control Mar 18, 2002
PHR of Baltimore, Inc.Baltimore, MD, CCN 217036 Home health agency Operational/Managerial Control Apr 21, 2000
PHR of Baltimore, Inc.Baltimore, MD, CCN 211512 Hospice Other Jun 6, 2006
Professional Healthcare Resources of Washington DC, Inc.Washington, DC, CCN 091506 Hospice Operational/Managerial Control
Other		 Sep 18, 2009
Sep 18, 2009
Professional Healthcare Resources, Inc.Annandale, VA, CCN 491599 Hospice Operational/Managerial Control May 3, 2010

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 7

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1912953548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 LITTLE RIVER TPKE",
            "address_2": "STE. 600",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032625",
            "telephone_number": "703-752-8700",
            "fax_number": "703-752-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7619 LITTLE RIVER TPKE",
            "address_2": "STE. 600",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032625",
            "telephone_number": "703-752-8700",
            "fax_number": "703-752-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTHCARE RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "TRIVIZAS",
        "authorized_official_first_name": "ELENI",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE",
        "authorized_official_telephone_number": "703-752-8700"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "497502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4973551",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annandale, VA

Sources for this page

Verify at the official NPI Registry.