Active NPI
Rockville Skilled Nursing & Rehabilitation Center, LLC
- Skilled Nursing Facility
- Rockville Centre, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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, 2012
- 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
- Ari Gluck
- Title
- Asst. Administrator
- Phone
- (516) 536-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01934812 | Medicaid | NY | |
| 2909304N | Other | NY | OPERATING # |
| 0517 | Other | NY | PFI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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,
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Aug 7, 1991
- Medicare certification status
- Active
- Certified beds
- 66
- Chain
- Benjamin Landa
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 |
|---|---|---|---|
| 33D2192907 | Rockville Skilled Nursing and Rehabilitation | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Mitchell Teller | 5% Or Greater Direct Ownership Interest | Jan 1, 1999 | 5% |
| Teddy Lichtschein | 5% Or Greater Direct Ownership Interest | Jan 1, 1999 | 50% |
| Susan Welge | W-2 Managing Employee | Jul 24, 2012 | |
| Benjamin Landa | 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.
-
- Adult Medicine Physician
- Rockville Centre, NY
- NPI 1992148647
-
- Internal Medicine Physician
- Oceanside, NY
- NPI 1750619722
-
- Internal Medicine Physician
- Far Rockaway, NY
- NPI 1285679498
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.