Active NPI
Truemed, Inc
- Home Health Agency
- South San Francisco, CA
National Provider Identifier
1962707406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- TRUEMED, INC
- Practice address
- 400 Oyster Point Blvd Ste 201
South San Francisco, CA 94080-1918 - Phone
- (650) 588-8331
- NPI assigned
- Jan 13, 2011
- 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
- Mr. Petr Kozakov
- Title
- Ceo
- Phone
- (650) 588-8331
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
400 Oyster Point Blvd Ste 201
South San Francisco, CA 94080-1918
Mailing address
205 Los Robles Dr
Burlingame, CA 94010-5927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110217000235 | CA | Part A Provider - Home Health Agency | 9739360207 | Practice locations: South San Francisco, CA |
Home health agency certification: CCN 059349
- Legal name
- TRUEMED, INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 23, 2011
- Last certification
- Dec 11, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Nov 8, 2010 in CA
- Enrollment address
- 400 Oyster Point Blvd 201
South San Francisco, CA 94080-1918
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
- Truemed, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 23, 2011
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Truemed
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Santa Rosa, CA
- NPI 1962158295
Locations
139 Mitchell Ave
Ste 119
South San Francisco, CA 94080
Ownership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Iliya Radinsky | 5% Or Greater Direct Ownership Interest | Dec 1, 2010 | 33.33% |
| Corporate Director | Dec 1, 2010 | ||
| Peter Kozakov | 5% Or Greater Direct Ownership Interest | Dec 1, 2010 | 33.33% |
| Corporate Director | Dec 1, 2010 | ||
| W-2 Managing Employee | Dec 1, 2010 | ||
| Simon Gleyzer | 5% Or Greater Direct Ownership Interest | Dec 1, 2010 | 33.33% |
| Corporate Director | Dec 1, 2010 |
Practitioners & affiliated clinicians
Affiliated clinicians 20
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- San Francisco, CA
- NPI 1104839620
Home health agency
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1497859433
Home health agency
-
- Internal Medicine Physician
- Walnut Creek, CA
- NPI 1104062173
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644192000000",
"number": "1962707406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 LOS ROBLES DR",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940105927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 OYSTER POINT BLVD STE 201",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940801918",
"telephone_number": "650-588-8331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRUEMED, INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-13",
"last_updated": "2022-02-07",
"certification_date": "2022-02-07",
"status": "A",
"authorized_official_last_name": "KOZAKOV",
"authorized_official_first_name": "PETR",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "650-588-8331",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.