West Colonial Drive Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WEST COLONIAL DRIVE OPCO LLC

Doing business as

Aviata at Colonial Lakes

Practice address

15204 W Colonial Dr
Winter Garden, FL 34787-6042

Phone

(407) 877-2394

Fax

(407) 877-6143

NPI assigned

Aug 1, 2023

Last updated

Apr 9, 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

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at Colonial Lakes Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023790060. Details of each certification follow.

• CCN 105440 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105440

Legal name

WEST COLONIAL DRIVE OPCO LLC

Doing business as

AVIATA AT COLONIAL LAKES

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Sep 12, 1983

Last certification

Jul 18, 2024

Beds

180

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Aviata Health Group

Organization structure

LLCProprietary

Incorporated

Jul 26, 2023 in FL

Enrollment address

15204 W Colonial Dr
Winter Garden, FL 34787-6042

Nursing home name

AVIATA AT COLONIAL LAKES

Affiliated entity

AVIATA HEALTH GROUP

Listed as

Aviata at Colonial LakesCCN 105440 · 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 - Limited Liability company

Certified

Sep 12, 1983

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

180169.6 residents per day on average

Chain

Aviata Health Group50 facilities in the chain

Penalties (3 years)

3Fines totaling $23,136

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

Owners & managing parties with NPI records 1

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

• Abhishek Mishra, MD

  • General Practice Physician
  • Orlando, FL
  • NPI 1053816587

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Abhishek Mishra, MD

  • General Practice Physician
  • Orlando, FL
  • NPI 1053816587
  NPD (past)

Affiliated clinicians 4

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

• Katherine Lopez Gordillo, MD

  • Internal Medicine Physician
  • Lake Mary, FL
  • NPI 1073999504

  Nursing home

  Care Compare affiliation
• Abhishek Mishra, MD

  • General Practice Physician
  • Orlando, FL
  • NPI 1053816587

  Nursing home

  Care Compare affiliation
• Eddie Irfan Murgasen, M.D.

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1336529437

  Nursing home

  Care Compare affiliation
• Tung Thanh Ho, M.D

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1861705477

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1023790060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042",
            "telephone_number": "407-877-2394",
            "fax_number": "407-877-6143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 W COLONIAL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347876042",
            "telephone_number": "407-877-2394",
            "fax_number": "407-877-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COLONIAL DRIVE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "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": "NU",
            "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 Colonial Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Welsh, MS, LMHC, CEAP
• Barbara Anne Wenczak, MD
• Gaati Werema
• Kelly A Wesolowski, CRNP, FNP-BC
• Amanda Marie Wesson, BCBA
• West Orange Family Medical Care,PA
• West Orange Healthcare District (Health Central Park)
• West Orange Healthcare District (Wintermere Internal Medicine)
• West Orange Massage Therapy LLC
• West Orange Nephrology LLC

• Skilled Nursing Facility in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.