Lodge at Brookline Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LODGE AT BROOKLINE OPERATIONS LLC

Practice address

5301 N Brookline Ave
Oklahoma City, OK 73112-3516

Phone

(832) 422-8848

NPI assigned

Apr 22, 2025

Last updated

Apr 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Ganz

Title

LLC Manager

Phone

(832) 422-8848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013704238. Details of each certification follow.

• CCN 375574 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 375574

Legal name

LODGE AT BROOKLINE OPERATIONS LLC

Doing business as

THE LODGE AT BROOKLINE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 18, 2018

Last certification

Sep 6, 2024

Beds

132

Ownership / control type

Corporation

Multi-facility organization

Dia Konas Group

Organization structure

LLCProprietary

Enrollment address

5301 N Brookline Ave
Oklahoma City, OK 73112-3516

Nursing home name

THE LODGE AT BROOKLINE

Affiliated entity

SKYBLUE HEALTHCARE

Listed as

The Lodge At BrooklineCCN 375574 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jun 18, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

13245.5 residents per day on average

Chain

Skyblue Healthcare12 facilities in the chain

Penalties (3 years)

2Fines totaling $25,057

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 14

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.

• Senthil K Raju, M.D.

  • Hospitalist Physician
  • Oklahoma City, OK
  • NPI 1922009075

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 7

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

• Colonial Manor Operations LLC

  • Skilled Nursing Facility
  • Tulsa, OK
  • NPI 1568259851

  Skyblue Healthcare Management LLC

  CMS ownership
• Franciscan Villa SNF Operations LLC

  • Skilled Nursing Facility
  • Broken Arrow, OK
  • NPI 1043007263

  Skyblue Healthcare Management LLC

  CMS ownership
• Omci Operations LLC

  • Skilled Nursing Facility
  • Tulsa, OK
  • NPI 1376330597

  Skyblue Healthcare Management LLC

  CMS ownership
• Warr Acres SNF Operations LLC

  • Skilled Nursing Facility
  • Warr Acres, OK
  • NPI 1093502213

  Skyblue Healthcare Management LLC

  CMS ownership
• Windsor Hills SNF Operations LLC

  • Skilled Nursing Facility
  • Oklahoma City, OK
  • NPI 1356138572

  Skyblue Healthcare Management LLC

  CMS ownership
• Stratford Hospital District

  dba Plainview Healthcare Center

  • Skilled Nursing Facility
  • Plainview, TX
  • NPI 1285762286

  Skyblue Healthcare Management LLC

  CMS ownership
• Stratford Hospital District

  dba Lakeside Rehabilitation and Care Center

  • Skilled Nursing Facility
  • Lubbock, TX
  • NPI 1992902498

  Skyblue Healthcare Management LLC

  CMS ownership

Affiliated clinicians 3

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

• Christopher Fisher, MD

  • Internal Medicine Physician
  • Edmond, OK
  • NPI 1306333414

  Nursing home

  Care Compare affiliation
• Daniel Kamugisha Mujuni, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
  • NPI 1457931545

  Nursing home

  Care Compare affiliation
• Senthil K Raju, M.D.

  • Hospitalist Physician
  • Oklahoma City, OK
  • NPI 1922009075

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1013704238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 N BROOKLINE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123516",
            "telephone_number": "832-422-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 N BROOKLINE AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123516",
            "telephone_number": "832-422-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODGE AT BROOKLINE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "LLC MANAGER",
        "authorized_official_telephone_number": "832-422-8848"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah J Lockwood, MD
• Landra Lockwood
• Robin Renette Lockwood, DDS
• Katie Lockyer, LPN
• Robin Marie Lodes, M.A,
• Heather Cowan Loeb
• Carol Ann Loeber, ARNP
• Vickie L Loemker, MD
• Georgia K Loew, BCBA
• Rachael Loffelmacher

• Skilled Nursing Facility in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Skilled Nursing Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.