NPIMap

Organization Active NPI

Incare Home Care, LLC

Doing business as InCare Home Health Services

  • Home Health Agency
  • Larkspur, CA
National Provider Identifier
1922511807
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
INCARE HOME CARE, LLC
Doing business as
InCare Home Health Services
Practice address
17 E Sir Francis Drake Blvd Ste 212
Larkspur, CA 94939-1727
Phone
(415) 673-8989
NPI assigned
Nov 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
James Kelly
Title
Cfo
Phone
(415) 526-5520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

17 E Sir Francis Drake Blvd Ste 212
Larkspur, CA 94939-1727

Mailing address

17 E Sir Francis Drake Blvd
Larkspur, CA 94939-1727
Phone (415) 927-2273

Other names 2

  • InCare Home Health Services Doing business as
  • InCare Home Care, LLC (disregarded entity) Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230914001565 CA Part A Provider - Home Health Agency 0042674673 Practice locations: Larkspur, CA

Home health agency certification: CCN 557798

Legal name
INCARE HOME CARE, LLC
Doing business as
BY THE BAY HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 17, 1997
Last certification
Feb 13, 2020
Ownership / control type
Non-Profit
Organization structure
LLCProprietary
Incorporated
Sep 18, 2017 in CA
Enrollment address
17 E Sir Francis Drake Blvd
Ste 212
Larkspur, CA 94939-1727

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
By the Bay HealthCCN 557798 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Apr 17, 1997
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
By the Bay Health2 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

17 E Sir Francis Drake Blvd
Ste 212
Larkspur, CA 94939
Phone (415) 673-8989

Ownership & related parties

All disclosed owners & managing parties 27

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

NameRoleSinceShare
Shelby D Decosta-Galdeira Individual Corporate DirectorBoard Director Aug 28, 2019
Stacy a Blanchard Individual Corporate Director Jan 1, 2024
Armika J Berkley Individual Corporate Director Jan 30, 2024
Gerald R Peters Individual Corporate DirectorBoard Director Jul 1, 1985
Lisa J Burleson Individual W-2 Managing EmployeeController Aug 5, 2020
Joyce Wilson Individual W-2 Managing EmployeeDPCS Jun 12, 2023
Robertina K Szolarova Individual Corporate OfficerCao Apr 23, 2018
Swaminathan Jayaraman Individual Corporate Director Jan 1, 2024
Fred Sanciangco Individual Corporate Director Jan 1, 2024
By the Bay Health Organization, Larkspur, CA Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2018 100%
Gregory a Leclaire Individual Corporate DirectorBoard Director, Treasurer Dec 16, 2020
Kenneth G Meislin Individual Corporate DirectorBoard Director Feb 10, 2009
Michelle S Mourad Individual Corporate DirectorBoard Director Aug 28, 2019
Tracy a Hogan Individual Corporate DirectorBoard Director Dec 16, 2020
James T Kelly Individual Corporate OfficerCfo Sep 1, 2019
Operational/Managerial ControlDirector of Finance Sep 1, 2019
Catherine Jamentz Individual Corporate Director Jan 1, 2024
Wendy C Chow Individual Corporate DirectorBoard Director, Secretary Dec 15, 2022
Skelly Wingard Individual Corporate OfficerCeo, Board Director Jun 19, 2023
Corporate DirectorCeo, Board Director Jun 29, 2023
Scott T Smith Individual Corporate DirectorBoard Director Jul 7, 2019
Jeff Gerard Individual Corporate Director Jan 1, 2024
Steven Z Pantilat Individual Corporate DirectorBoard Director May 12, 2015
Kaija-Leena Romero Individual Contracted Managing EmployeeCmo Feb 1, 2020
Corporate OfficerCmo Feb 1, 2020
Daniel E Cohn Individual Corporate DirectorBoard Director Feb 27, 2014
Mukund Acharya Individual Corporate Director Jan 1, 2024
Robert J Simon Individual Corporate DirectorChair and Board Director Mar 1, 2011
Michael a Kadel Individual Corporate DirectorVice Chair and Board Director Sep 1, 2009
Julie a Smith Individual W-2 Managing EmployeeReimbursement Manager Sep 1, 2008

Owners & managing parties with NPI records 5

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1922511807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E SIR FRANCIS DRAKE BLVD",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391727",
            "telephone_number": "415-927-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E SIR FRANCIS DRAKE BLVD STE 212",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391727",
            "telephone_number": "415-673-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCARE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-526-5520"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InCare Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "InCare Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "InCare Home Care, LLC (disregarded entity)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Larkspur, CA

Sources for this page

Verify at the official NPI Registry.