3415 Greencastle Road Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

3415 GREENCASTLE ROAD OPCO LLC

Practice address

3415 Greencastle Rd
Burtonsville, MD 20866-1715

Phone

(240) 970-5600

NPI assigned

May 9, 2022

Organization subpart

No

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

Addresses

Other names 1

• Autumn Lake Healthcare at Oak Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Skilled nursing facility certification: CCN 215315

Legal name

3415 GREENCASTLE ROAD OPCO LLC

Doing business as

AUTUMN LAKE HEALTHCARE AT OAK MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 24, 1998

Last certification

Feb 19, 2025

Beds

145

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

3415 Greencastle Rd
Burtonsville, MD 20866-1715

Nursing home name

AUTUMN LAKE HEALTHCARE AT OAK MANOR

Affiliated entity

AUTUMN LAKE HEALTHCARE

Listed as

Autumn Lake Healthcare at Oak ManorCCN 215315

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Dec 24, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

145126.9 residents per day on average

Chain

Autumn Lake Healthcare59 facilities in the chain

Penalties (3 years)

1Fines totaling $11,381

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 9

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

Owners & managing parties with NPI records 1

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

• Ramesh Sabapathi, MD

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730118993

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 3

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

• Usha Gollapalli, M.D.

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1235136672
  NPD (past)
• Dorothy M Seay, M.D.

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1255376539
  NPD (past)
• Narita Surana, M.D.

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1982744512
  NPD (past)

Affiliated clinicians 3

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

• Ramesh Sabapathi, MD

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730118993

  Nursing home

  Care Compare affiliation
• Dorothy M Seay, M.D.

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1255376539

  Nursing home

  Care Compare affiliation
• Narita Surana, M.D.

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1982744512

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1003552480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "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": "3415 GREENCASTLE RD",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661715",
            "telephone_number": "240-970-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3415 GREENCASTLE ROAD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "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 at Oak Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Autumn Lake Healthcare at Oak Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 14 Starz Home Care
• Manahlosh Degu Abegaz, CNA
• Adama Abu
• Hannah Acquah, NP-C
• Lolali Adade-Helledy, PMHNP-BC
• Gary Deane Adams, D.D.S.

• Skilled Nursing Facility in Burtonsville, MD
• Providers in Burtonsville, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.