NPIMap

Organization Active NPI

TLC Skilled Health Care Providers, Inc.

Doing business as Prime Nursing Services Inc

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1962409813
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980000768 Issued in CA
Legal business name
TLC SKILLED HEALTH CARE PROVIDERS, INC.
Doing business as
Prime Nursing Services Inc
Practice address
3250 Wilshire Blvd
Suite # 1008
Los Angeles, CA 90010-1577
Phone
(213) 380-9991
Fax
(213) 387-2894
NPI assigned
Jul 7, 2005
Last updated
Sep 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Miss Maria Asuncion Polintan Tatoy
Title
Ceo/ Administrator
Phone
(213) 380-9991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980000768 CA Primary

Addresses

Primary practice location

3250 Wilshire Blvd
Suite # 1008
Los Angeles, CA 90010-1577

Mailing address

3250 Wilshire Blvd
Suite # 1008
Los Angeles, CA 90010-1577
Phone (213) 380-9991

Other names 1

  • PRIME NURSING SERVICES INC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071114000589 CA Part A Provider - Home Health Agency 6002904661 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962409813. Details of each certification follow.

Home health agency certification: CCN 057497

Legal name
TLC SKILLED HEALTH CARE PROVIDERS, INC.
Doing business as
PRIME NURSING SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 13, 1994
Last certification
Dec 3, 2017
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 16, 1992 in CA
Enrollment address
3250 Wilshire Blvd
Ste 1008
Los Angeles, CA 90010-1512
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prime Nursing ServicesCCN 057497 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
May 13, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0892755Prime Nursing Services3250 Wilshire Blvd Ste 1008, Los Angeles, CA 90010Certificate of waiverOct 4, 2026

National Provider Directory

National Provider Directory

Locations

3250 Wilshire Blvd
Ste 1008
Los Angeles, CA 90010
Phone (213) 380-9991

3250 Wilshire Blvd
Ste 1612
Los Angeles, CA 90010
Phone (213) 380-9991

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Maria P Tatoy Individual 5% Or Greater Direct Ownership InterestOwner Jan 1, 2014 100%
Corporate OfficerCeo/Cfo Jan 1, 2014 100%
Corporate DirectorCeo/Cfo Jan 1, 2014 100%
W-2 Managing EmployeeAdminstrator Jan 1, 2014 100%
Mila Casenas Individual W-2 Managing EmployeeDPCS and Administrator Designee Mar 19, 2019 50%
Isabelita S Bulaon Individual Corporate OfficerCorporate Secretary Dec 16, 1998 10%
Gopal Govindarajan Individual Contracted Managing EmployeeMedical Director Mar 8, 2012 25%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1962409813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 WILSHIRE BLVD",
            "address_2": "SUITE # 1008",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101577",
            "telephone_number": "213-380-9991",
            "fax_number": "213-387-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WILSHIRE BLVD",
            "address_2": "SUITE # 1008",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101577",
            "telephone_number": "213-380-9991",
            "fax_number": "213-387-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC SKILLED HEALTH CARE PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "TATOY",
        "authorized_official_first_name": "MARIA ASUNCION",
        "authorized_official_middle_name": "POLINTAN",
        "authorized_official_title_or_position": "CEO/ ADMINISTRATOR",
        "authorized_official_telephone_number": "213-380-9991",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980000768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME NURSING SERVICES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.