NPIMap

Organization Active NPI

Parkway Manor Health Center, LLC

  • Skilled Nursing Facility
  • East Orange, NJ
National Provider Identifier
1104061472
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PARKWAY MANOR HEALTH CENTER, LLC
Practice address
480 N Walnut St
East Orange, NJ 07017-4029
Phone
(973) 674-2700
NPI assigned
Dec 15, 2008
Last updated
Mar 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Moshe Frost
Title
Controller
Phone
(732) 364-2672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

480 N Walnut St
East Orange, NJ 07017-4029

Mailing address

480 N Walnut St
East Orange, NJ 07017-4029

Other identifiers 1

IdentifierTypeStateIssuer
4475704MedicaidNJ

Other names 1

  • Park Crescent Healthcare & Rehabilitation Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090312000022 NJ Part A Provider - Skilled Nursing Facility 1951467232 Practice locations: East Orange, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104061472. Details of each certification follow.

Skilled nursing facility certification: CCN 315266

Legal name
PARKWAY MANOR HEALTH CENTER, LLC
Doing business as
PARK CRESCENT HEALTHCARE & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 21, 1988
Last certification
Feb 22, 2024
Beds
190
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 28, 2008 in NJ
Enrollment address
480 N Walnut St( Parkway Dr)
East Orange, NJ 07017-4029
Nursing home name
PARK CRESCENT HEALTHCARE & REHABILITATION CENTER
Affiliated entity
OCEAN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Park Crescent Healthcare & Rehabilitation CenterCCN 315266 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 21, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
190173.4 residents per day on average
Chain
Ocean Healthcare11 facilities in the chain
Penalties (3 years)
1Fines totaling $15,240

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Individual Direct Ownership Interest Dec 30, 2008 1.5%
Shemon Singer Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 17.75%
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 17.75%
Individual Direct Ownership Interest Dec 30, 2008 1.5%
Individual Direct Ownership Interest Dec 30, 2008 1%
Individual Direct Ownership Interest Dec 30, 2008 1%
Michael Berman Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 17.5%
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 17.5%
Individual Adp of the SNF Jan 1, 2009
Deborah F Feigenbaum Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 14.75%
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 14.75%
Avraham R Feigenbaum Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 13%
Operational/Managerial Control Dec 30, 2008
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 13%
Dynamic Healthcare Management LLC Organization, Lakewood, NJ LLC, Management services company, Consulting firm Operational/Managerial Control Jan 1, 2009
Adp of the SNF Jun 17, 2025
Organization, Lakewood, NJ LLC, For-profit Adp of the SNF Jan 1, 2009
Avrohom Y Maierovits Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 5%
Operational/Managerial Control Dec 30, 2008
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 5%
Tzvi Florans Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Oct 23, 2023
Organization, Brooklyn, NY Corporation Adp of the SNF Jun 17, 2025
Zalman L Drew Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 13%
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 13%
Individual Direct Ownership Interest Dec 30, 2008 2%
Joseph Meisels Individual 5% Or Greater Direct Ownership Interest Dec 30, 2008 10%
Adp of the SNF Dec 30, 2008
Direct Ownership Interest Dec 30, 2008 10%
M&T Bank Organization, Buffalo, NY Financial institution 5% Or Greater Mortgage Interest Sep 1, 2014 52%
Individual Direct Ownership Interest Dec 30, 2008 2%
Organization, Lakewood, NJ LLC, For-profit Adp of the SNF Jun 17, 2025

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1104061472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 N WALNUT ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070174029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N WALNUT ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070174029",
            "telephone_number": "973-674-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY MANOR HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "732-364-2672"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4475704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Crescent Healthcare & Rehabilitation Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.