NPIMap

Organization Active NPI

Post-Acute Care Center Opco LLC

  • Skilled Nursing Facility
  • Baltimore, MD
National Provider Identifier
1003386780
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
POST-ACUTE CARE CENTER OPCO LLC
Practice address
5009 Frankford Avenue
Baltimore, MD 21206-5353
Phone
(410) 325-4000
NPI assigned
Nov 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(877) 567-0402

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X Primary
Respite Care 385H00000X

Addresses

Primary practice location

5009 Frankford Avenue
Baltimore, MD 21206-5353

Mailing address

14C 53Rd St Ste 220
Brooklyn, NY 11232-2644
Phone (877) 567-0402

Other names 1

  • Autumn Lake Healthcare Post Acute Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190321002728 MD Part A Provider - Skilled Nursing Facility 3274872452 Practice locations: Baltimore, MD

Skilled nursing facility certification: CCN 215330

Legal name
POST-ACUTE CARE CENTER OPCO LLC
Doing business as
POST-ACUTE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 17, 2000
Last certification
Mar 21, 2023
Beds
225
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Nov 13, 2018 in DE
Enrollment address
5009 Frankford Ave
Baltimore, MD 21206-5353
Nursing home name
AUTUMN LAKE HEALTHCARE POST-ACUTE CARE CENTER
Affiliated entity
AUTUMN LAKE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Autumn Lake Healthcare Post-Acute Care CenterCCN 215330
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 17, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
225204.0 residents per day on average
Chain
Autumn Lake Healthcare59 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
A&R Stern Family PA Holdings LLC Organization, Howell, NJ LLC Adp of the SNF Jun 18, 2019
Pacc Holdco LLC Organization, Howell, NJ Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 18, 2019 100%
Jason Fenelon Individual Operational/Managerial Control Nov 11, 2022
Adp of the SNF Nov 11, 2022
Aryeh Stern Individual 5% Or Greater Indirect Ownership Interest Jun 18, 2019 50%
Andres Eduardo Salazar Individual Operational/Managerial Control Feb 18, 2019
Adp of the SNF Feb 18, 2019
Siyata Dshmaya LLC Organization, Howell, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 18, 2019 8%
Adp of the SNF Jun 18, 2019
Pacc Realty Holdco LLC Organization, Howell, NJ Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jun 18, 2019 100%
Adp of the SNF Jun 18, 2019
Mark Schwartz Individual Corporate OfficerCfo Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Organization, Brooklyn, NY LLC Adp of the SNF Jun 16, 2025
Morris Meisels Individual 5% Or Greater Indirect Ownership Interest Jun 18, 2019 42%
Adp of the SNF Jun 18, 2019
Organization, Brooklyn, NY Adp of the SNF Jun 16, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Andres Salazar
    • Geriatric Medicine (Family Medicine) Physician
    • Ellicott City, MD
    • NPI 1265594493

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 7

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

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1003386780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 FRANKFORD AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065353",
            "telephone_number": "410-325-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POST-ACUTE CARE CENTER OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare Post Acute Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.