Active NPI
Elite Home Health Group Inc
- Home Health Agency
- Pasadena, CA
National Provider Identifier
1962053496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ELITE HOME HEALTH GROUP INC
- Practice address
- 232 N Lake Ave Ste 215
Pasadena, CA 91101-1862 - Phone
- (626) 349-6002
- NPI assigned
- Sep 25, 2019
- 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
- Artur Mnatsakanyan
- Title
- Ceo
- Phone
- (626) 349-6002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
232 N Lake Ave Ste 215
Pasadena, CA 91101-1862
Mailing address
232 N Lake Ave Ste 215
Pasadena, CA 91101-1862
Phone (626) 349-6002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210111002314 | CA | Part A Provider - Home Health Agency | 0648683771 | Practice locations: Los Angeles, CA |
Home health agency certification: CCN 559565
- Legal name
- ELITE HOME HEALTH GROUP INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 30, 2021
- Last certification
- Mar 30, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Apr 30, 2020 in CA
- Enrollment address
- 2829 N San Fernando Rd
Ste 201
Los Angeles, CA 90065-1344
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Elite Home Health Group
- Overall star rating
- Ownership
- Proprietary
- Certified
- Mar 30, 2021
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
2829 N San Fernando Rd
Ste 201
Los Angeles, CA 90065
Phone (626) 349-6002
232 N Lake Ave
Ste 215
Pasadena, CA 91101
Phone (626) 349-6002
Ownership & 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 |
|---|---|---|---|
| Artur Mnatsakanyan | 5% Or Greater Direct Ownership Interest | Apr 30, 2019 | 100% |
| Corporate Officer | Apr 30, 2019 | 100% | |
| Corporate Director | Apr 30, 2019 | 100% | |
| W-2 Managing Employee | Apr 30, 2019 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1569369600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612137600000",
"number": "1962053496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 N LAKE AVE STE 215",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011862",
"telephone_number": "626-349-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 N LAKE AVE STE 215",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011862",
"telephone_number": "626-349-6002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE HOME HEALTH GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-25",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A",
"authorized_official_last_name": "MNATSAKANYAN",
"authorized_official_first_name": "ARTUR",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "626-349-6002"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.