NPIMap

Organization Active NPI

Massapequa Center LLC

  • Skilled Nursing Facility
  • Amityville, NY
National Provider Identifier
1104355536
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MASSAPEQUA CENTER LLC
Practice address
101 Louden Ave.
Amityville, NY 11701
Phone
(631) 264-0222
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Joel Edelstein
Title
Manager
Phone
(718) 888-5206

Specialties & licenses 1

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

Addresses

Primary practice location

101 Louden Ave.
Amityville, NY 11701

Mailing address

101 Louden Ave.
Amityville, NY 11701
Phone (631) 264-0222

Other practice location 1

399 County Line Road
Amityville, NY 11701
Phone (718) 888-5200 ext. 205

Other identifiers 1

IdentifierTypeStateIssuer
00314181MedicaidNY

Other names 1

  • Massapequa Center Rehabilitation and Nursing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171116002886 NY Part A Provider - Skilled Nursing Facility 8527324938 Practice locations: Amityville, NY

Skilled nursing facility certification: CCN 335213

Legal name
MASSAPEQUA CENTER LLC
Doing business as
MASSAPEQUA CENTER REHABILITATION & NURSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1967
Last certification
Dec 11, 2024
Beds
320
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Kennedy Healthcare
Most recent change of ownership
Nov 21, 2017
Organization structure
LLCProprietary
Incorporated
Sep 15, 2016 in NY
Enrollment address
101 Louden Ave
Amityville, NY 11701-2736
Nursing home name
MASSAPEQUA CENTER REHABILITATION & NURSING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Massapequa Center Rehabilitation & NursingCCN 335213
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
Apr 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
320284.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Massapequa Center Adult Day Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Charles Edelstein Individual Direct Ownership Interest Dec 1, 2017 2.5%
Avraham M Weits Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 10%
Joel Edelstein Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 15.5%
Adp of the SNF Nov 20, 2017
Direct Ownership Interest Nov 20, 2017 15.5%
Aharon Bleier Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 5%
Leah Sod Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 5%
Tova L Fuchs Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 15.5%
Adp of the SNF Nov 20, 2017
Direct Ownership Interest Nov 20, 2017 15.5%
Mordechai Aryeh Greenfield Individual Operational/Managerial Control Mar 4, 2025
Adp of the SNF Mar 24, 2026
Olaf Butchma Individual Operational/Managerial Control Jan 1, 2021
Adp of the SNF Apr 14, 2026
Gerald B Fuchs Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 15.5%
Adp of the SNF Nov 20, 2017
Direct Ownership Interest Nov 20, 2017 15.5%
Bernard Fuchs Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 15.5%
Direct Ownership Interest Nov 20, 2017 15.5%
Israel D Freund Individual 5% Or Greater Direct Ownership Interest Sep 15, 2016 15.5%
Adp of the SNF Nov 20, 2017
Direct Ownership Interest Nov 20, 2017 15.5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 7

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": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1104355536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LOUDEN AVE.",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-264-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LOUDEN AVE.",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "11701",
            "telephone_number": "631-264-0222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 County Line Road",
            "address_purpose": "LOCATION",
            "city": "Amityville",
            "state": "NY",
            "postal_code": "11701",
            "country_code": "US",
            "telephone_number": "718-888-5200 x205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MASSAPEQUA CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-888-5206"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00314181",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Massapequa Center Rehabilitation and Nursing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Massapequa Center Rehabilitation and Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.