NPIMap

Organization Active NPI

Bernardo Heights Healthcare, Inc.

Doing business as Carmel Mountain Rehabilitation and Healthcare Center

  • Skilled Nursing Facility
  • San Diego, CA
National Provider Identifier
1083727093
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
080000315 Issued in CA
Legal business name
BERNARDO HEIGHTS HEALTHCARE, INC.
Doing business as
Carmel Mountain Rehabilitation and Healthcare Center
Practice address
11895 Avenue of Industry
San Diego, CA 92128-3423
Phone
(858) 673-0101
Fax
(858) 673-8320
NPI assigned
Aug 16, 2006
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 080000315 CA Primary

Addresses

Primary practice location

11895 Avenue of Industry
San Diego, CA 92128-3423

Mailing address

11895 Avenue of Industry
San Diego, CA 92128-3423
Phone (858) 673-0101

Other identifiers 1

IdentifierTypeStateIssuer
LTC55326KMedicaidCA

Other names 1

  • Carmel Mountain Rehabilitation and Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060119000245 CA Part A Provider - Skilled Nursing Facility 7911921762 Practice locations: San Diego, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083727093. Details of each certification follow.

Skilled nursing facility certification: CCN 555326

Legal name
BERNARDO HEIGHTS HEALTHCARE, INC.
Doing business as
CARMEL MOUNTAIN REHABILITATON AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 12, 1988
Last certification
Apr 24, 2025
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Flagstone
Most recent change of ownership
Mar 1, 2006
Organization structure
CorporationProprietary
Incorporated
Nov 23, 2005 in NV
Enrollment address
11895 Avenue of Industry
San Diego, CA 92128-3423
Nursing home name
CARMEL MOUNTAIN REHABILITATION & HEALTHCARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Carmel Mountain Rehabilitation & Healthcare CenterCCN 555326 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 12, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120114.9 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0711967Carmel Mountain Rehabilitation & Healthcare Center11895 Avenue of Industry, San Diego, CA 92128Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Glenn Matthews Individual Operational/Managerial ControlAdministrator Apr 1, 2013
Managing Control - Governing BodyAdministrator Apr 1, 2013
Adp of the SNF Apr 1, 2013
Katherine Oh Individual Corporate OfficerPresident Bernardo Heights Healthca Sep 9, 2024
Sevenoaks Capital Associates LLC Organization, Dallas, TX LLC Operational/Managerial Control Mar 1, 2006
Barry Port Individual Corporate DirectorSole Manger Flagstone Healthcare So Jan 22, 2015
CM Health Holdings LLC Organization, Mission Viejo, CA LLC Adp of the SNF Mar 1, 2006
Lincare Inc Organization, Atlanta, GA Corporation Operational/Managerial Control Mar 1, 2006
Cetna Staffing Inc Organization, San Diego, CA Corporation Operational/Managerial Control Mar 1, 2006
The Ensign Group Inc Organization, Mission Viejo, CA Corporation 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
Adp of the SNF Jan 30, 2006
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Mar 1, 2006
Adam Willits Individual Corporate OfficerDirector Bernardo Heights Healthcar Mar 1, 2006
Ami Sato Individual Corporate OfficerTreasurer Bernardo Heights Healthca Sep 9, 2024
Flagstone Healthcare South LLC Organization, Mission Viejo, CA LLC 5% Or Greater Direct Ownership Interest Jan 30, 2006 100%
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Mar 1, 2006
Caretrust GP LLC Organization, San Clemente, CA Corporation Adp of the SNF Mar 1, 2006
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Mar 1, 2006
Chad Keetch Individual Corporate OfficerSee Below Mar 1, 2011
Michael E Kalafer Individual Operational/Managerial Control Mar 22, 2016
Managing Control - Governing BodyMedical Director Mar 22, 2016
Adp of the SNF Mar 22, 2016
Soon Burnam Individual Corporate OfficerSecretary Bernardo Heights Healthca Sep 9, 2024
Managing Control - Governing BodyAuthorized Official Sep 9, 2024

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 37

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

View all 37

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1083727093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11895 AVENUE OF INDUSTRY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283423",
            "telephone_number": "858-673-0101",
            "fax_number": "858-673-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11895 AVENUE OF INDUSTRY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283423",
            "telephone_number": "858-673-0101",
            "fax_number": "858-673-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARDO HEIGHTS HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "080000315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55326K",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Carmel Mountain Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carmel Mountain Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.