Pine Acres Rehabilitation and Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PINE ACRES REHABILITATION AND CARE CENTER LLC

Practice address

1501 Office Park Rd
West Des Moines, IA 50265-2497

Phone

(515) 223-1223

NPI assigned

Jan 20, 2021

Last updated

Jan 25, 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

Yisroel Kaplan

Title

Manager

Phone

(515) 223-1223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043800386. Details of each certification follow.

• CCN 165350 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165350

Legal name

PINE ACRES REHABILITATION AND CARE CENTER LLC

Doing business as

PINE ACRES REHABILITATION AND CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 22, 1997

Last certification

Dec 19, 2024

Beds

140

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

1501 Office Park Rd
West Des Moines, IA 50265-2497

Nursing home name

PINE ACRES REHABILITATION AND CARE CENTER

Listed as

Pine Acres Rehabilitation and Care CenterCCN 165350 · All quality measures

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 22, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

14083.3 residents per day on average

Special focus status

SFF

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

4Fines totaling $478,835

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 10

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.

• Andrew Bishop, D.O.

  • Internal Medicine Physician
  • Johnston, IA
  • NPI 1689088817

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• Andrew Bishop, D.O.

  • Internal Medicine Physician
  • Johnston, IA
  • NPI 1689088817

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1043800386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 OFFICE PARK RD",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652497",
            "telephone_number": "515-223-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 OFFICE PARK RD",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652497",
            "telephone_number": "515-223-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE ACRES REHABILITATION AND CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "YISROEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "515-223-1223"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Pietig, LMFT
• Malkan Pilipovic, ARNP
• Kelvin Pimentel, PHARMD
• Thomas Watkins Pinckney, DDS
• Pine Acres Assisted Living LLC
• James George Piros, M.D.
• Jennifer Marie Pitlick, DPT
• Madison Sue Pleggenkuhle, TLMHC
• Ambrose David Poduska
• Darrius Poe, DC

• Skilled Nursing Facility in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.