Active NPI
Procare Home Health LLC
- Home Health Agency
- Las Vegas, NV
National Provider Identifier
1942954896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- PROCARE HOME HEALTH LLC
- Practice address
- 6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846 - Phone
- (702) 372-8140
- NPI assigned
- Feb 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tadesse Kebede
- Title
- Owner/President
- Phone
- (702) 372-8140
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846
Mailing address
6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846
Phone (702) 372-8140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230224000466 | NV | Part A Provider - Home Health Agency | 0749653699 | Practice locations: Las Vegas, NV |
Home health agency certification: CCN 297340
- Legal name
- PROCARE HOME HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 1, 2024
- Last certification
- Feb 1, 2024
- Organization structure
- LLC
- Incorporated
- Feb 9, 2022 in VA
- Enrollment address
- 6655 W Sahara Ave
Ste D110
Las Vegas, NV 89146-0846
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Procare Home Health LLC
- Overall star rating
- Ownership
- -
- Certified
- Feb 1, 2024
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2269557 | Procare Home Health LLC | Certificate of waiver | Sep 27, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Tadesse Kebede | 5% Or Greater Direct Ownership Interest | Feb 9, 2022 | 100% |
| Corporate Director | Feb 9, 2022 | 100% | |
| W-2 Managing Employee | Feb 9, 2022 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 5
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": "1644364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644364800000",
"number": "1942954896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6655 W SAHARA AVE STE D110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891460846",
"telephone_number": "702-372-8140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 W SAHARA AVE STE D110",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891460846",
"telephone_number": "702-372-8140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROCARE HOME HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-09",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A",
"authorized_official_last_name": "KEBEDE",
"authorized_official_first_name": "TADESSE",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "702-372-8140"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.