NPIMap

Organization Active NPI

Sapphire at Gresham Rehab, LLC

  • Skilled Nursing Facility
  • Gresham, OR
National Provider Identifier
1033740899
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SAPPHIRE AT GRESHAM REHAB, LLC
Practice address
405 NE 5TH St
Gresham, OR 97030-7345
Phone
(503) 666-5600
Fax
(503) 907-8911
NPI assigned
Jan 30, 2020
Last updated
Nov 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Authorized official

Name
Kevin Michael Ricker
Title
Managing Member
Phone
(503) 887-7395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

405 NE 5TH St
Gresham, OR 97030-7345

Mailing address

305 NE 102ND Ave Ste 250
Portland, OR 97220-4170
Phone (503) 446-2877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040130000799 OR Part B Supplier - Clinic/Group Practice 5799688230 Receives reassigned benefits from 3,391 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Salem, OR; Tigard, OR; Tualatin, OR; Mount Angel, OR; Beaverton, OR; Clackamas, OR; Eugene, OR…
O20200424002900 OR Part A Provider - Skilled Nursing Facility 3779912670 Practice locations: Gresham, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033740899. Details of each certification follow.

Skilled nursing facility certification: CCN 385190

Legal name
SAPPHIRE AT GRESHAM REHAB, LLC
Doing business as
GRESHAM POST ACUTE CARE AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 23, 1989
Last certification
Aug 30, 2024
Beds
78
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Sapphire Health Care
Organization structure
LLCProprietary
Enrollment address
405 NE 5TH St
Gresham, OR 97030-7345
Nursing home name
GRESHAM POST ACUTE CARE AND REHABILITATION
Affiliated entity
SAPPHIRE HEALTH SERVICES

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gresham Post Acute Care and RehabilitationCCN 385190 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 23, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7871.1 residents per day on average
Chain
Sapphire Health Services8 facilities in the chain
Penalties (3 years)
2Fines totaling $76,801

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

9900 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-8240

Networks

  • devoted network organization-54bc88f0-8c1c-41b6-b022-755ebfe4d22c

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
Organization, Portland, OR LLC, Holding company Adp of the SNF Apr 1, 2020
Sapphire Healthcare SRVS. Organization, Portland, OR LLC, Management services company Operational/Managerial Control Apr 1, 2020
Adp of the SNF Oct 7, 2025
Andrew L Becker Individual 5% Or Greater Direct Ownership InterestManager Jan 6, 2020 30%
Lisa J Hilty Individual 5% Or Greater Direct Ownership InterestManager Jan 6, 2020 25%
Kameron Ferdowsali Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Kevin Ricker Individual 5% Or Greater Direct Ownership InterestManager Jan 6, 2020 40%
David Welker Individual Operational/Managerial Control Aug 12, 2024
Adp of the SNF Aug 12, 2024
Bryan Morris Individual 5% Or Greater Direct Ownership InterestManager Jan 6, 2020 5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

Affiliated clinicians 1

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": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764288000000",
    "number": "1033740899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE 102ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204170",
            "telephone_number": "503-446-2877",
            "fax_number": "971-230-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NE 5TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307345",
            "telephone_number": "503-666-5600",
            "fax_number": "503-907-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAPPHIRE AT GRESHAM REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A",
        "authorized_official_last_name": "RICKER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-887-7395"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.