Organization Active NPI

Rockville Skilled Nursing & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Rockville Centre, NY
National Provider Identifier
1093708646
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ROCKVILLE SKILLED NURSING & REHABILITATION CENTER, LLC
Practice address
50 Maine Ave
Rockville Centre, NY 11570-3608
Phone
(516) 536-8000
NPI assigned
Aug 30, 2005
Last updated
Sep 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Authorized official

Name
Ari Gluck
Title
Asst. Administrator
Phone
(516) 536-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

50 Maine Ave
Rockville Centre, NY 11570-3608

Mailing address

50 Maine Ave
Rockville Centre, NY 11570-3608
Phone (516) 536-8000

Other identifiers 3

IdentifierTypeStateIssuer
01934812MedicaidNY
2909304NOtherNYOPERATING #
0517OtherNYPFI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000575 NY Part A Provider - Skilled Nursing Facility 5799769360 Practice locations: Rockville Centre, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093708646. Details of each certification follow.

Skilled nursing facility certification: CCN 335747

Legal name
ROCKVILLE SKILLED NURSING & REHABILITATION CENTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 7, 1991
Last certification
Dec 22, 2023
Beds
66
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Dec 30, 1998 in NY
Enrollment address
50 Maine Ave
Rockville Centre, NY 11570-3608
Nursing home name
ROCKVILLE SKILLED NURSING & REHABILITATION CENTER, LLC
Affiliated entity
BENJAMIN LANDA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rockville Skilled Nursing & Rehabilitation Center,CCN 335747 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 7, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6664.3 residents per day on average
Chain
Benjamin Landa48 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
33D2192907Rockville Skilled Nursing and Rehabilitation50 Maine Ave, Rockville Centre, NY 11570Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Mitchell Teller Individual 5% Or Greater Direct Ownership Interest Jan 1, 1999 5%
Teddy Lichtschein Individual 5% Or Greater Direct Ownership Interest Jan 1, 1999 50%
Susan Welge Individual W-2 Managing Employee Jul 24, 2012
Benjamin Landa Individual 5% Or Greater Direct Ownership Interest Jan 1, 1999 45%

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

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": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1093708646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MAINE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703608",
            "telephone_number": "516-536-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MAINE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703608",
            "telephone_number": "516-536-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKVILLE SKILLED NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "GLUCK",
        "authorized_official_first_name": "ARI",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "516-536-8000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01934812",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING #",
            "identifier": "2909304N",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFI",
            "identifier": "0517",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.