NPIMap

Organization Active NPI

Bala Nursing & Ret CNTR LTD Ptrshp Ford Rd Corp

  • Skilled Nursing Facility
  • Philadelphia, PA
National Provider Identifier
1023168283
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
041402 Issued in PA
Legal business name
BALA NURSING & RET CNTR LTD PTRSHP FORD RD CORP
Practice address
4001 Ford Rd
Philadelphia, PA 19131-2833
Phone
(215) 877-5400
Fax
(215) 871-3110
NPI assigned
Jan 11, 2007
Last updated
Sep 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Authorized official

Name
Mr. Todd Roberts
Title
Controller
Phone
(215) 877-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 041402 PA Primary

Addresses

Primary practice location

4001 Ford Rd
Philadelphia, PA 19131-2833

Mailing address

4001 Ford Rd
Philadelphia, PA 19131-2833
Phone (215) 877-5400

Other identifiers 6

IdentifierTypeStateIssuer
19203OtherPASENIOR PARTNERS
606828OtherPAAETNA PROVIDER NUMBER
KEYSTONE MERCYOtherPA1059563
BLUE CROSSOtherPABLUE CROSS
0011856700001MedicaidPA
8133OtherPAELDER HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120508000265 PA Part A Provider - Skilled Nursing Facility 0547422651 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023168283. Details of each certification follow.

Skilled nursing facility certification: CCN 396076

Legal name
BALA NURSING & RET CNTR LTD PTRSHP FORD RD CORP
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 26, 2001
Last certification
Jan 13, 2025
Beds
180
Ownership / control type
Partnership
Organization structure
PartnershipProprietary
Enrollment address
4001 Ford Rd
Philadelphia, PA 19131-2833
Nursing home name
MONUMENTALPOSTACUTECARE AT WOODSIDE PARK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Monumentalpostacutecare at Woodside ParkCCN 396076 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Feb 26, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
18049.5 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $30,752

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

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
Robert Miller Individual 5% Or Greater Direct Ownership Interest Nov 30, 1989
Direct Ownership Interest Nov 30, 1989 5%
Angela Wells Individual Corporate DirectorAdministrator Mar 30, 2019 100%
Operational/Managerial Control Mar 30, 2019
Michael Miller Individual 5% Or Greater Direct Ownership Interest Nov 30, 1989
Direct Ownership Interest Nov 30, 1989 5%
Philip Miller Individual 5% Or Greater Direct Ownership Interest Nov 30, 1989 5%
Direct Ownership Interest Nov 30, 1989 5%
Individual Adp of the SNF Mar 30, 2019
Stephanie Miller-Greenburg Individual 5% Or Greater Direct Ownership Interest Nov 30, 1989
Direct Ownership Interest Nov 30, 1989 5%
Individual Adp of the SNF Dec 21, 2023
David B Miller Individual 5% Or Greater Direct Ownership Interest Nov 30, 1989
Adp of the SNF Nov 30, 1989
Direct Ownership Interest Nov 30, 1989 5%

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 5

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1023168283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 FORD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312833",
            "telephone_number": "215-877-5400",
            "fax_number": "215-871-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 FORD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312833",
            "telephone_number": "215-877-5400",
            "fax_number": "215-871-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALA NURSING & RET CNTR LTD PTRSHP FORD RD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "215-877-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "041402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENIOR PARTNERS",
            "identifier": "19203",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "606828",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1059563",
            "identifier": "KEYSTONE MERCY",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BLUE CROSS",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011856700001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER HEALTH",
            "identifier": "8133",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.