Kairos Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

KAIROS HOME CARE LLC

Practice address

4510 Peralta Blvd
Suite #7
Fremont, CA 94536-5755

Phone

(510) 358-2271

Fax

(510) 358-2278

NPI assigned

Apr 22, 2015

Last updated

Apr 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Gina Rachel Mangunay Romero, RN

Title

Administrator/DPCS Designee

Phone

(510) 303-9860

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932596459. Details of each certification follow.

• CCN 059758 Home health agency · Active · Details

Home health agency certification: CCN 059758

Legal name

KAIROS HOME CARE LLC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 21, 2016

Last certification

Oct 11, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Mar 30, 2015 in CA

Enrollment address

39210 State St
Ste 106
Fremont, CA 94538-1456

Listed as

Kairos Home Care LLCCCN 059758 · All quality measures

Overall star rating

5 of 5

Ownership

Proprietary

Certified

Nov 21, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 2

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

Practitioners 1

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.

• Gabrielle M. Romero, OTD, OTR/L

  • Occupational Therapist
  • Fremont, CA
  • NPI 1972194967
  NPD

Affiliated clinicians 4

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

• Bala P Annadurai, M.D.

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1033100516

  Home health agency

  Care Compare affiliation
• Rabin Khetrapal, MD

  • Internal Medicine Physician
  • Fremont, CA
  • NPI 1629180310

  Home health agency

  Care Compare affiliation
• Natalia Marissa Roberts, FNP

  • Nurse Practitioner
  • Fairfield, CA
  • NPI 1255901799

  Home health agency

  Care Compare affiliation
• Rajesh Sam Suri, MD

  • Cardiovascular Disease Physician
  • Fremont, CA
  • NPI 1790700987

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1932596459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 PERALTA BLVD",
            "address_2": "#7",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365755",
            "telephone_number": "510-358-2271",
            "fax_number": "510-358-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 PERALTA BLVD",
            "address_2": "SUITE #7",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365755",
            "telephone_number": "510-358-2271",
            "fax_number": "510-358-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIROS HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "GINA RACHEL",
        "authorized_official_middle_name": "MANGUNAY",
        "authorized_official_title_or_position": "ADMINISTRATOR/DPCS DESIGNEE",
        "authorized_official_telephone_number": "510-303-9860",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravinder - Kahlon, M.D.
• Vasdeep Singh Kahlon, M.D.
• Clementina Kaikai
• Kain II DDS Michael Lai DDS Inc
• Meghana Kaipa
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Niles 3 Phy 164)
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Niles 2 Phy)
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Niles Pharmacy 161)
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Ohlone Phy 162)
• Kaiser Foundation Health Plan Inc

• Home Health Agency in Fremont, CA
• Providers in Fremont, 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 Apr 19, 2017; 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.