NPIMap

Organization Active NPI

Extraordinary Home Care

  • Home Health Agency
  • Uniondale, NY
National Provider Identifier
1962728071
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EXTRAORDINARY HOME CARE
Practice address
333 Earle Ovington Blvd Ste 600
Uniondale, NY 11553-3622
Phone
(718) 281-8600
NPI assigned
Apr 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Ms. Frederique Altidor
Title
Manager
Phone
(718) 281-8688

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NY Primary
Home Health Agency 251E00000X

Addresses

Primary practice location

333 Earle Ovington Blvd Ste 600
Uniondale, NY 11553-3622

Mailing address

333 Earle Ovington Blvd Ste 600
Uniondale, NY 11553-3622
Phone (718) 281-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100823001129 NY Part A Provider - Home Health Agency 0042334344 Practice locations: New Hyde Park, NY

Home health agency certification: CCN 337438

Legal name
EXTRAORDINARY HOME CARE
Doing business as
ST. MARY'S HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 9, 2011
Last certification
Aug 16, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Feb 4, 2010 in NY
Enrollment address
5 Dakota Dr
Ste 200
New Hyde Park, NY 11042-1109

Care Compare: Home health agency

Medicare Care Compare
Listed as
St Mary'S Home CareCCN 337438
Ownership
Non-Profit
Certified
Feb 9, 2011
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
33D2007879Extraordinary Home Care D/B/a St Marys Home Care333 Earle Ovington Blvd - Suite 600, Uniondale, NY 11553Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

510 Broadhollow Rd
Ste 202
Melville, NY 11747
Phone (631) 755-1809

333 Earle Ovington Blvd
Ste 600
Uniondale, NY 11553
Phone (516) 621-2681

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Celia Cannata Individual Operational/Managerial Control Jan 21, 2009
Elvira Fardella-Roveto Individual W-2 Managing EmployeeDirector of Professional Service Dec 26, 2010
William Mead Individual Corporate OfficerChief Operating Officer Chie Fin Oct 10, 2014
Corporate DirectorCoo-CF) Oct 10, 2014
Beata Jalowski Individual Operational/Managerial Control Dec 1, 2013
Edwin F Simpser Individual Corporate OfficerCeo Dec 5, 2010
Corporate DirectorCeo Dec 5, 2010

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

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1962728071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD STE 600",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533622",
            "telephone_number": "718-281-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 EARLE OVINGTON BLVD STE 600",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115533622",
            "telephone_number": "718-281-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRAORDINARY HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "ALTIDOR",
        "authorized_official_first_name": "FREDERIQUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-281-8688",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniondale, NY

Sources for this page

Verify at the official NPI Registry.