SJV 1 Madison Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SJV 1 MADISON OPCO LLC

Doing business as

Sunrise of Madison

Practice address

215 Madison Ave
Madison, NJ 07940-1003

Phone

(973) 301-0005

Fax

(973) 301-0022

NPI assigned

Mar 26, 2021

Last updated

Mar 26, 2021By 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

Michael Depeola

Title

Director of Operations

Phone

(973) 301-0005

Specialties & licenses 1

Addresses

Other names 1

• Sunrise of Madison Doing business as

Tax ID family

SJV 1 Madison Opco LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• SJV 1 Madison Opco LLC

  dba Sunrise of Madison

  • Assisted Living Facility
  • Madison, NJ
  • NPI 1962097600
  NPD tax ID

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1033796925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MADISON AVE",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401003",
            "telephone_number": "973-301-0005",
            "fax_number": "973-301-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MADISON AVE",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079401003",
            "telephone_number": "973-301-0005",
            "fax_number": "973-301-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJV 1 MADISON OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "DEPEOLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "973-301-0005"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise of Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Swati Shembde, P.T.
• Carl Laurence Shesler, D.MIN.
• Hong Y Shi, MD
• Shervin Shojai, DDS
• Thomas Paul Shubeck, PH.D.
• SJV 1 Madison Opco LLC (Sunrise of Madison)
• Jillian Slater
• Alice Smarsh, PT
• Joanna M Smith, LCSW
• Shirley L Smith, RN APN

• Skilled Nursing Facility in Madison, NJ
• Providers in Madison, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.