Organization Active NPI

7520 Surratts Opco LLC

Doing business as Autumn Lake Healthcare at Bradford Oaks

  • Skilled Nursing Facility
  • Clinton, MD
National Provider Identifier
1013593888
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
7520 SURRATTS OPCO LLC
Doing business as
Autumn Lake Healthcare at Bradford Oaks
Practice address
7520 Surratts Rd
Clinton, MD 20735-3353
Phone
(877) 567-0402
NPI assigned
Mar 22, 2021
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

7520 Surratts Rd
Clinton, MD 20735-3353

Mailing address

14C 53Rd St
Brooklyn, NY 11232-2644

Other names 1

  • Autumn Lake Healthcare at Bradford Oaks Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518003050 MD Part A Provider - Skilled Nursing Facility 1951700277 Practice locations: Clinton, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013593888. Details of each certification follow.

Skilled nursing facility certification: CCN 215165

Legal name
7520 SURRATTS OPCO LLC
Doing business as
AUTUMN LAKE HEALTHCARE AT BRADFORD OAKS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 4, 1987
Last certification
Feb 20, 2025
Beds
180
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Dec 29, 2020 in MD
Enrollment address
7520 Surratts Rd
Clinton, MD 20735-3353
Nursing home name
AUTUMN LAKE HEALTHCARE AT BRADFORD OAKS
Affiliated entity
AUTUMN LAKE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Autumn Lake Healthcare at Bradford OaksCCN 215165 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 4, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180170.4 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 9

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

NameRoleSinceShare
Brand Sonnenschine LLP Organization, Brooklyn, NY Operational/Managerial Control May 1, 2021
Adp of the SNF May 24, 2025
Accurate Staffing LLC Organization, Brooklyn, NY LLC, Medical staffing company Operational/Managerial Control May 1, 2021
Adp of the SNF May 24, 2025
7520 Surratts Holdco LLC Organization, Howell, NJ Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2021 100%
Ofo Muo Individual Operational/Managerial Control Aug 21, 2023
Adp of the SNF Aug 23, 2021
Aryeh Stern Individual Indirect Ownership Interest May 1, 2021 1%
A&R Stern Family MD1 Holdings LLC Organization, Howell, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2021 74.15%
Hatzlacha Rabbah LLC Organization, Howell, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2021 24.85%
Mark Schwartz Individual Corporate OfficerCfo May 1, 2021
Operational/Managerial Control May 1, 2021
Kamal Salah Sewaralthahab Individual Adp of the SNF Jun 1, 2023

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1013593888",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353353",
            "telephone_number": "877-567-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "7520 SURRATTS OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "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 Bradford Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.