NPIMap

Organization Active NPI

Professional Healthcare Resources of Washington DC, Inc

  • Community Based Hospice Care Agency
  • Washington, DC
National Provider Identifier
1922320076
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC
Practice address
501 School St SW
Suite 200
Washington, DC 20024-2754
Phone
(703) 752-8700
NPI assigned
Feb 17, 2010
Last updated
May 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Brian Clemens
Title
Director of Finance
Phone
(703) 752-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

501 School St SW
Suite 200
Washington, DC 20024-2754

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040823001112 DC Part A Provider - Home Health Agency 3678547981 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, DC
O20100325000116 DC Part A Provider - Hospice 3678547981 Practice locations: Washington, DC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1922320076. Details of each certification follow.

Home health agency certification: CCN 097049

Legal name
PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 21, 2000
Last certification
Aug 9, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 24, 1999 in DC
Enrollment address
501 School St SW
Ste 200
Washington, DC 20024-2774

Hospice certification: CCN 091506

Legal name
PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 17, 2010
Last certification
Aug 18, 2016
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 24, 1999 in DC
Enrollment address
501 School St SW
Ste 200
Washington, DC 20024-2774

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Professional HealthcareCCN 097049 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Apr 21, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
Professional Healthcare Resources of Washington DCCCN 091506 · All quality measures
Ownership
For-Profit
Certified
Aug 17, 2010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Professional Healthcare Resources of Washington DC 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

501 School St SW
Ste 200
Washington, DC 20024
Phone (202) 955-8355

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
D'Andrea Brown Individual Operational/Managerial ControlSenior Clinical Director Oct 30, 2023
Professional Healthcare Resources, Inc. Organization, Annandale, VA Operational/Managerial Control Apr 21, 2000
Operational/Managerial Control Sep 18, 2009
Other Sep 18, 2009
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 5, 2000 45%
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%
5% Or Greater Direct Ownership Interest Dec 12, 2003 100%
Eileen Decesare Individual Corporate OfficerPresident and Board Chair Jun 24, 1999
Corporate DirectorPresident and Board Chair Sep 30, 2004
Corporate OfficerPresident Board Chair Jun 24, 1999
Corporate DirectorPresident Board Chair Sep 18, 2009
OtherPresident Board Chair Feb 29, 2008 2.6%
Beverly Dean Individual W-2 Managing EmployeeAdministrator May 6, 2019
Operational/Managerial ControlAdministrator May 6, 2019
Pilar Z Godoy Individual Corporate OfficerBoard Treasurer Jun 24, 1999
Corporate DirectorBoard Treasurer Director Jun 24, 1999

Owners & managing parties with NPI records 2

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1922320076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 LITTLE RIVER TPKE",
            "address_2": "SUITE 600",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032625",
            "telephone_number": "703-752-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SCHOOL ST SW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200242754",
            "telephone_number": "703-752-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTHCARE RESOURCES OF WASHINGTON DC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "703-752-8700"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.