Active NPI
Elite Infusion Services LLC
- Home Health Agency
- West Palm Beach, FL
National Provider Identifier
1972195279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ELITE INFUSION SERVICES LLC
- Practice address
- 560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945 - Phone
- (561) 766-0612
- NPI assigned
- Feb 8, 2021
- 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. Angel Antonio Abrego, LPN
- Title
- Owner
- Phone
- (561) 766-0612
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945
Mailing address
560 Village Blvd Ste 325a
West Palm Beach, FL 33409-1945
Phone (561) 766-0612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221214002854 | FL | Part A Provider - Home Health Agency | 3375912397 | Practice locations: West Palm Beach, FL |
Home health agency certification: CCN 687282
- Legal name
- ELITE INFUSION SERVICES LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 11, 2023
- Last certification
- Sep 11, 2023
- Organization structure
- LLC
- Incorporated
- Nov 20, 2020 in FL
- Enrollment address
- 560 Village Blvd
# 325A
West Palm Beach, FL 33409-1945
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Elite Infusion Services LLC
- Overall star rating
- Ownership
- -
- Certified
- Sep 11, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2251058 | Elite Infusion Services LLC | Certificate of waiver | Jan 31, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Angel Abrego | 5% Or Greater Direct Ownership Interest | Aug 24, 2020 | 50% |
| Corporate Director | Aug 24, 2020 | 50% | |
| W-2 Managing Employee | Aug 24, 2020 | 50% | |
| Daine Guevara | 5% Or Greater Direct Ownership Interest | Aug 24, 2020 | 50% |
| Corporate Director | Aug 24, 2020 | 50% | |
| W-2 Managing Employee | Aug 24, 2020 | 50% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612742400000",
"number": "1972195279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 VILLAGE BLVD STE 325A",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334091945",
"telephone_number": "561-766-0612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 VILLAGE BLVD STE 325A",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334091945",
"telephone_number": "561-766-0612"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE INFUSION SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-08",
"last_updated": "2021-02-08",
"certification_date": "2021-02-08",
"status": "A",
"authorized_official_last_name": "ABREGO",
"authorized_official_first_name": "ANGEL",
"authorized_official_middle_name": "ANTONIO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "561-766-0612",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LPN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Palm Beach, FL
- Midge Wirline Elinor
- Sandra Florence Elisabeth Lawson
- Elite Care Transportation, Inc.
- Elite Companion and Homemaker Services, LLC
- Elite Homehealth Care Services LLC
- Elite Premier Nursing Services LLC
- Elite Primary Care LLC
- Elite Transport Services
- Elizabeth Trinidad, M.D., P.a.
- Anis Elkhechen, D.M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.