NPIMap

Organization Active NPI

West Fletcher Ave Opco LLC

  • Skilled Nursing Facility
  • Tampa, FL
National Provider Identifier
1003595174
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WEST FLETCHER AVE OPCO LLC
Practice address
518 W Fletcher Ave
Tampa, FL 33612-3419
Phone
(813) 265-1600
Fax
(813) 964-0505
NPI assigned
Jul 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Nathan Freund
Title
Manager
Phone
(732) 730-7480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

518 W Fletcher Ave
Tampa, FL 33612-3419

Mailing address

518 W Fletcher Ave
Tampa, FL 33612-3419
Phone (813) 265-1600

Other names 1

  • Aviata at Fletcher Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Consulate Health Care

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231211003000 FL Part A Provider - Skilled Nursing Facility 4981053394 Practice locations: Tampa, FL

Skilled nursing facility certification: CCN 105644

Legal name
WEST FLETCHER AVE OPCO LLC
Doing business as
AVIATA AT FLETCHER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Mar 1, 1989
Last certification
Jul 11, 2024
Beds
120
Ownership / control type
Individual
Most recent change of ownership
Sep 1, 2023
Organization structure
LLCProprietary
Incorporated
Jul 5, 2023 in FL
Enrollment address
518 W Fletcher Ave
Tampa, FL 33612-3419
Nursing home name
AVIATA AT FLETCHER
Affiliated entity
AVIATA HEALTH GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Aviata at FletcherCCN 105644
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Mar 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120114.0 residents per day on average
Chain
Aviata Health Group50 facilities in the chain
Penalties (3 years)
2Fines totaling $57,962

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0941610Aviata at Fletcher518 W Fletcher Ave, Tampa, FL 33612Certificate of waiverFeb 26, 2028

National Provider Directory

National Provider Directory

Networks

  • AL HMO D-SNP

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Aspire MGT LLC Organization, Jackson, NJ LLC, For-profit, Chain home office Adp of the SNF Sep 1, 2023
Nochum Freund Individual Corporate OfficerCoo Sep 1, 2023
Operational/Managerial Control Sep 1, 2023
Cassandra Rabago-Reyes Individual Operational/Managerial Control Sep 1, 2023
Adp of the SNF Sep 1, 2023
Tampa Holdco LLC Organization, Jackson, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Sep 1, 2023 100%
Organization, Brooklyn, NY Adp of the SNF Jul 21, 2025
Shelva Burns Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
West Fletcher Parent LLC Organization, Jackson, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Sep 1, 2023 100%
Organization, Springfield, MO Adp of the SNF Jul 21, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1003595174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123419",
            "telephone_number": "813-265-1600",
            "fax_number": "813-964-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123419",
            "telephone_number": "813-265-1600",
            "fax_number": "813-964-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FLETCHER AVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at Fletcher",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.