NPIMap

Organization Active NPI

Ridgecrest Nursing and Rehab LLC

  • Skilled Nursing Facility
  • Deland, FL
National Provider Identifier
1033867478
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RIDGECREST NURSING AND REHAB LLC
Practice address
1200 N Stone St
Deland, FL 32720-2511
Phone
(386) 734-4334
NPI assigned
Mar 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Moshe Scheiner
Title
Authorized Official
Phone
(845) 490-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1200 N Stone St
Deland, FL 32720-2511

Mailing address

1200 N Stone St
Deland, FL 32720-2511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220915001563 FL Part A Provider - Skilled Nursing Facility 2466837216 Practice locations: Deland, FL

Skilled nursing facility certification: CCN 106061

Legal name
RIDGECREST NURSING AND REHAB LLC
Doing business as
RIDGECREST HEALTHCARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 3, 2004
Last certification
Feb 22, 2024
Beds
146
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 25, 2022 in DE
Enrollment address
1200 N Stone St
Deland, FL 32720-2511
Nursing home name
RIDGECREST HEALTHCARE AND REHABILITATION CENTER
Affiliated entity
GOLD FL TRUST II

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ridgecrest Healthcare and Rehabilitation CenterCCN 106061
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 3, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
146124.9 residents per day on average
Chain
Gold FL Trust II36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Networks

  • 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)
  • 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 Maximo (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)…

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ridgecrest Nursing and Rehab Holdco LLC Organization, Montebello, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 25, 2022 100%
Silver FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%
Copper FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 10%
FL Master Opco Holdco LLC Organization, Miami, FL Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 27, 2022 95.01%
Gold FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%
Moshe Y Lazar Individual Corporate Officer Jul 27, 2022 100%
Nathaniel Gittner Individual W-2 Managing EmployeeAdministrator Jul 27, 2022 100%

Facilities with the same owner 34

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

View all 34

Practitioners & affiliated clinicians

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": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1033867478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202511",
            "telephone_number": "386-734-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "SCHEINER",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-490-6060"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.