Blue Pacific Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLUE PACIFIC HOME HEALTH

Practice address

5658 Sepulveda Blvd Ste 210
Van Nuys, CA 91411-2951

Phone

(818) 947-8787

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Suzanna Hovhannisyan

Title

Ceo

Phone

(818) 947-8787

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757346

Legal name

BLUE PACIFIC HOME HEALTH

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 26, 2023

Last certification

Jun 15, 2023

Organization structure

CorporationProprietary

Enrollment address

12444 Victory Blvd
Ste 305
North Hollywood, CA 91606-3199

Listed as

Blue Pacific Home HealthCCN 757346

Overall star rating

3 of 5

Ownership

-

Certified

Jun 26, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Tarek Ezzeddine, MD

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1740471879

  Home health agency

  Care Compare affiliation
• Gilbert Emile Faustina, MD

  • Surgery Physician
  • West Covina, CA
  • NPI 1558303271

  Home health agency

  Care Compare affiliation
• Evelyn Ganaden Basco, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1669531679

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1972194165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 SEPULVEDA BLVD STE 210",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112951",
            "telephone_number": "818-947-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 SEPULVEDA BLVD STE 210",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112951",
            "telephone_number": "818-947-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PACIFIC HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "HOVHANNISYAN",
        "authorized_official_first_name": "SUZANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-947-8787"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Home Health, Inc.
• Blue Horizon Home Health Care
• Blue Hospice, Inc.
• Blue Iris Hospice, in.
• Blue Oak Medical Group
• Blue Sky Home Health Care Services, Inc
• Blue Sky Home Health Care, Inc.
• Blue Sky Hospice Care, Inc.
• Blue Sky Hospice Inc
• Allison Blumenthal, D.O.

• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.

Verify at the official NPI Registry.