Active NPI
Ag Monrovia, LLC
Doing business as Monrovia Gardens Healthcare Center
- Skilled Nursing Facility
- Monrovia, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 950000013
- Legal business name
- AG MONROVIA, LLC
- Doing business as
- Monrovia Gardens Healthcare Center
- Practice address
- 615 West Duarte Road
Monrovia, CA 91016 - Phone
- (626) 358-4547
- Fax
- (626) 303-5788
- NPI assigned
- Sep 9, 2005
- Last updated
- Jul 18, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob Wintner
- Title
- Manager
- Phone
- (323) 651-1808
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 950000013 | CA | Primary |
Addresses
Primary practice location
615 West Duarte Road
Monrovia, CA 91016
Mailing address
615 West Duarte Road
Monrovia, CA 91016
Phone (626) 358-4547
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT05367I | Medicaid | CA |
Other names 1
- Monrovia Gardens Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031023000037 | CA | Part A Provider - Skilled Nursing Facility | 0446162119 | Practice locations: Monrovia, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1043204522. Details of each certification follow.
Skilled nursing facility certification: CCN 055367
- Legal name
- AG MONROVIA, LLC
- Doing business as
- MONROVIA GARDENS HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 31, 1971
- Last certification
- Oct 31, 2024
- Beds
- 96
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Cambridge Healthcare Services, LLC
- Organization structure
- LLC
- Incorporated
- Aug 11, 2003 in CA
- Enrollment address
- 615 W. Duarte Rd
Monrovia, CA 91016-4436 - Nursing home name
- MONROVIA GARDENS HEALTHCARE CENTER
- Affiliated entity
- CAMBRIDGE HEALTHCARE SERVICES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Monrovia Gardens Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 31, 1971
- Medicare certification status
- Active
- Certified beds
- 96
- Chain
- Cambridge Healthcare Services
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0699982 | Ag Monrovia, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Miguel Vidales | Operational/Managerial Control | Mar 1, 2021 | |
| Managing Control - Governing Body | Mar 1, 2021 | ||
| Adp of the SNF | Mar 1, 2021 | ||
| BH Alliance | 5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 5% |
| Linda Lutz | Operational/Managerial Control | Feb 1, 2012 | |
| Adp of the SNF | Feb 1, 2012 | ||
| Ira E Smedra Living Trust | 5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 47.5% |
| Win Win Enterprises, LLC | 5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 47.5% |
| Adp of the SNF | Oct 1, 2003 | ||
| Lance a Hassell | Operational/Managerial Control | Apr 25, 2022 | |
| Adp of the SNF | Apr 25, 2022 | ||
| 615 W. Duarte, LLC | Adp of the SNF | Oct 1, 2003 | |
| Cambridge Healthcare Services LLC | Operational/Managerial Control | Oct 1, 2013 | |
| Adp of the SNF | Oct 24, 2025 | ||
| Ira Smedra | 5% Or Greater Indirect Ownership Interest | Aug 11, 2003 | 47.5% |
| Operational/Managerial Control | Aug 11, 2003 | ||
| Adp of the SNF | Aug 11, 2003 | ||
| Ag Facilities Operations, LLC | 5% Or Greater Direct Ownership Interest | Aug 11, 2003 | 100% |
| Jacob Wintner | Corporate Officer | Aug 11, 2003 | 50% |
| Operational/Managerial Control | Aug 11, 2003 | ||
| Jacob Wintner | Adp of the SNF | Aug 11, 2003 | |
| Donald B Balacuit | Operational/Managerial Control | Apr 18, 2024 | |
| Adp of the SNF | Apr 18, 2024 | ||
| Paulina Salazar | Operational/Managerial Control | Dec 14, 2020 | |
| Adp of the SNF | Dec 14, 2020 | ||
| Julie Butenko | Operational/Managerial Control | Jul 24, 2023 | |
| Adp of the SNF | Jul 24, 2023 | ||
| Jaspal Sohal | Operational/Managerial Control | Oct 22, 2024 | |
| Managing Control - Governing Body | Oct 22, 2024 | ||
| Adp of the SNF | Oct 24, 2025 | ||
| Hayley Cruz | Operational/Managerial Control | Apr 1, 2025 | |
| Heidi Capela | Operational/Managerial Control | Apr 3, 2023 | |
| Adp of the SNF | Apr 3, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Monrovia, CA
- NPI 1598737116
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 31
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Mountain View Convalescent Hospital
- Skilled Nursing Facility
- Sylmar, CA
- NPI 1184619827
Cambridge Healthcare Services LLC, Win Win Enterprises, LLC
-
dba Valley Palms Care Center
- Skilled Nursing Facility
- North Hollywood, CA
- NPI 1801881479
Cambridge Healthcare Services LLC, Win Win Enterprises, LLC
-
dba buena vista care center
- Skilled Nursing Facility
- Anaheim, CA
- NPI 1740275486
Win Win Enterprises, LLC
-
dba Anaheim Crest Nursing Center
- Skilled Nursing Facility
- Anaheim, CA
- NPI 1568457299
Win Win Enterprises, LLC
-
dba Briarcrest Nursing Center
- Skilled Nursing Facility
- Bell Gardens, CA
- NPI 1548255284
Cambridge Healthcare Services LLC, Win Win Enterprises, LLC
-
dba Huntington Drive Health & Rehabilitation Center
- Skilled Nursing Facility
- Arcadia, CA
- NPI 1649264292
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Country Manor La Mesa Healthcare Center
- Skilled Nursing Facility
- La Mesa, CA
- NPI 1457345001
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Laguna Hills Health & Rehabilitation Center
- Skilled Nursing Facility
- Laguna Hills, CA
- NPI 1720072374
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Lynwood Healthcare Center
- Skilled Nursing Facility
- Lynwood, CA
- NPI 1144214628
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Murrieta Health & Rehabilitation Center
- Skilled Nursing Facility
- Murrieta, CA
- NPI 1174517650
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Rancho Mirage Health & Rehabilitation Center
- Skilled Nursing Facility
- Rancho Mirage, CA
- NPI 1164416657
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
-
dba Highland Care Center of Redlands
- Skilled Nursing Facility
- Redlands, CA
- NPI 1790779288
Ag Facilities Operations, LLC, BH Alliance, Cambridge Healthcare Services LLC, Ira E Smedra Living Trust, Win Win Enterprises, LLC
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1126224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1405641600000",
"number": "1043204522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 WEST DUARTE ROAD",
"city": "MONROVIA",
"state": "CA",
"postal_code": "91016",
"telephone_number": "626-358-4547",
"fax_number": "310-574-1322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 WEST DUARTE ROAD",
"city": "MONROVIA",
"state": "CA",
"postal_code": "91016",
"telephone_number": "626-358-4547",
"fax_number": "626-303-5788"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AG MONROVIA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-09",
"last_updated": "2014-07-18",
"status": "A",
"authorized_official_last_name": "WINTNER",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "323-651-1808"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "950000013",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT05367I",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Monrovia Gardens Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Monrovia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.