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PROHEALTH HOME CARE INC
NPI 1497720767
Home Health in Waukesha, WI


Patient Care Rating: 4 out of 5 stars

NPI Status: Active since February 21, 2006

Contact Information

2000 PEWAUKEE RD C
WAUKESHA, WI
ZIP 53188
Phone: (262) 928-7444
Fax: (262) 928-7446

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Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Insurance Plans Accepted
  4. Authorized Official
  5. Nursing Home Compare Information
  6. NPI Validation
  7. Frequently Asked Questions
  • Organization
  • Home Health
  • Accepts Insurance

About PROHEALTH HOME CARE INC

This page provides the complete NPI Profile along with additional information for Prohealth Home Care Inc, a provider established in Waukesha, Wisconsin operating as a Home Health. The healthcare provider is registered in the NPI registry with number 1497720767 assigned on February 2006. The practitioner's primary taxonomy code is 251E00000X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mr. Thomas W Johnson (Reimbursement Manager)

NPI
1497720767
Provider Name
PROHEALTH HOME CARE INC
Entity Type
Organization
Location Address
2000 PEWAUKEE RD C WAUKESHA, WI 53188
Location Phone
(262) 928-7444
Location Fax
(262) 928-7446
Mailing Address
2000 PEWAUKEE RD C WAUKESHA, WI 53188
Mailing Phone
(262) 928-7444
Mailing Fax
(262) 928-7446
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-21-2006
Last Update Date
04-20-2016
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According to the Home Health Compare program data, Prohealth Home Care Inc has an above average overall quality rating based on the provider's performance on seven separate quality measures including: timely initiation of care, improvement in ambulation, bed transferring, bathing, shortness of breath, management of oral medications and relapse in acute care hospitalizations. The Quality of Patient Star Rating for this provider is 4 out of 5 and summarizes some of the current health care provider performance measures.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Home Health

Taxonomy Code
251E00000X
Type
Agencies
Taxonomy Description
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Network Health

  • Prestige Bronze $0 Medical Deductible - HMO
  • Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
  • Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
  • Prestige Bronze Essential + 3 Free PCP Visits - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
  • Prestige Gold Essential + 3Free PCP Visits - HMO
  • Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Silver - HMO
  • Prestige Silver Essential + 3 Free PCP Visits - HMO
  • Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO

UnitedHealthcare

  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. THOMAS W JOHNSON

Authorized Official Title
REIMBURSEMENT MANAGER
Authorized Official Phone
(262) 928-4704

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
41515100MEDICAID (05)WI 
6001234OTHER (01)WIUNITED HEALTH CARE
527178MEDICARE ID-TYPE UNSPECIFIED (04)WI 

Nursing Home Compare Information

The Centers for Medicare and Medicaid Services publishes Home Health Compare quality of care data to provide consumers an easy way to compare "Medicare-certified" home health agencies throughout the nation. "Medicare-certified" home health agencies are approved by Medicare and meet certain federal health and safety requirements.

The Home Health Compare information helps consumers learn how well home health agencies care for their patients, how often each agency used best practices when caring for its patients and what patients said about their recent home health care experience.

Quality of Patient Care Rating Quality of Patient Care Rating
The quality of patient care star rating summarizes 8 of the 23 quality measures reported on Home Health Compare. It provides a single indicator of an agency's performance compared to other agencies.		 - 4 out of 5 stars - PROHEALTH HOME CARE performed better than most other agencies on selected measures.
Ownership Type Ownership Type
Home health agencies can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations or government entities. The type of ownership may affect agency resources and how services are organized. Quality can vary in home health agencies within each of the different types of ownership. Each agency needs to be judged on its own merits.		NonProfit
Offers Nursing Care Offers Nursing Care?
The home health agency offers care given or supervised by registered nurses. Nurses provide direct care; manage, observe, and evaluate a patient’s care; and teach the patient and his or her family caregiver. Examples include: giving IV drugs, shots, or tube feedings; changing dressings; and teaching about diabetes care. Any service that could be done safely by a non-medical person (or by yourself) without the supervision of a nurse isn’t skilled nursing care. Medicare covers home health skilled nursing care that's part time and intermittent.		Yes
Offers Physical Therapy Offers Physical Therapy?
The home health agency offers treatment of injury and disease by mechanical means, like heat, light, exercise, and massage.		Yes
Offers Occupational Therapy Offers Occupational Therapy?
The home health agency offers services given to help you return to usual activities (like bathing, preparing meals, and housekeeping) after illness either on an inpatient or outpatient basis.		Yes
Offers Speech Therapy Offers Speech Therapy?
The home health agency offers services to assist with problems involving speech, language, and swallowing. Communication problems can be present at birth or develop after an injury or illness, like a stroke.		Yes
Offers Medical Social Services Medical Social Services?
The home health agency offers services to help with social and emotional concerns related to your illness. This might include counseling or help in finding resources in your community.		Yes
Offers Home Health Aide Offers Home Health Aide?
The home health agency offers part time or intermittent services to help with daily living activities.		Yes
Medicare Certification Date01-23-1986
Number of episodes used to calculate how much Medicare spends at this agency Number of episodes used to calculate how much Medicare spends at this agency
Number of episodes of care used to calculate how much Medicare spends on an episode of care at this agency, compared to Medicare spending across all agencies nationally.		2,556
How often patients got better at walking or moving around? How often patients got better at walking or moving around?
This quality measure shows the percentage of home health quality episodes during which the patient improved in ability to ambulate.		88.1%
How often patients got better at getting in and out of bed? How often patients got better at getting in and out of bed?
This quality measure shows the percentage of home health quality episodes during which the patient improved in ability to get in and out of bed.		88.8%
How often patients got better at bathing? How often patients got better at bathing?
This quality measure shows the percentage of home health quality episodes during which the patient got better at bathing self.		89%
How often patients' breathing improved? How often patients' breathing improved?
This quality measure shows the percentage of home health quality episodes during which the patient became less short of breath or dyspneic.		88.6%
How often the home health team began their patients' care in a timely manner? How often the home health team began their patients' care in a timely manner?
This quality measure shows the percentage of episodes of care initiated or resumed on the date the physician ordered, or within within 24-48 hours of referral.		100%
How often patients got better at taking their drugs correctly by mouth? How often patients got better at taking their drugs correctly by mouth?
This quality measure shows the percentage of home health quality episodes during which the patient improved in ability to take their medicines correctly (by mouth).		84.2%
How often the home health team made sure that their patients have received a flu shot for the current flu season? How often the home health team made sure that their patients have received a flu shot for the current flu season?
This quality measure shows the percentage of home health quality episodes during which patients received the influenza immunization for the current flu season.		79.9%
How often physician-recommended actions to address medication issues were completed timely? How often physician-recommended actions to address medication issues were completed timely?
This quality measure shows the percentage of home health quality episodes forwhich a drug regimen review was conducted at the start of care or resumption of care and completion of recommended actions from timely follow-up with a physician occurred each time potential clinically significant medication issues were identified throughout that quality episode.		99.9%
Percent of Residents Experiencing One or More Falls with Major Injury How often a patient had one or more falls with a major injury?
This measure reports the percentage of patients who suffer falls that may result in major injuries and are a risk for patients living at the health home.		0.8%
Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment How often a patient has an admission and discharge functional assessment and an admission care plan that addresses function?
This measure displays hows how often the home health team completed a functional assessment for patients at both admission and discharge, and developed a functional care plan at admission.		100%
How much Medicare spends on an episode of care at this agency, compared to Medicare spending across all agencies nationally? How much Medicare spends on an episode of care at this agency, compared to Medicare spending across all agencies nationally?
This measure evaluates Home Health resource use relative to the resource use of the national median of all Home Health providers. Specifically, the measure assesses the Medicare spending performed by the Home Health provider and other healthcare providers during an MSPB-PAC episode.		0.96%
Changes in skin integrity post-acute care: pressure ulcer/injury Changes in skin integrity post-acute care: pressure ulcer/injury
This measure reports the percentage of patient stays with Stage 2-4 pressure ulcers, or unstageable pressure ulcers due to slough/eschar, non-removable dressing/device, or deep tissue injury, that are new or worsened since admission.		0.3%

Reviews for PROHEALTH HOME CARE INC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1497720767, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
7
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 7 → 14 → 5 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 1 + 4 + 2 + 0 + 7 + 1 + 2 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1497720767.

Frequently Asked Questions

What is PROHEALTH HOME CARE INC's NPI number?

The NPI number assigned to this healthcare provider is 1497720767, enumerated as an "organization" on February 21, 2006.

Where is the provider located?

The provider is located at 2000 PEWAUKEE RD C WAUKESHA, WI 53188 and the phone number is (262) 928-7444.

What is the provider's specialty?

Home Health with taxonomy code 251E00000X.

What insurance does PROHEALTH HOME CARE INC accept?

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Network Health,. Please consult your insurance carrier or call the provider to verify.