Active NPI
Portland SNF Operations, LLC
- Skilled Nursing Facility
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PORTLAND SNF OPERATIONS, LLC
- Practice address
- 12441 SE Stark St
Portland, OR 97233-1053 - Phone
- (503) 255-7040
- NPI assigned
- Jan 11, 2023
- 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
- Yitzchok Yenowitz
- Title
- Authorized Representative
- Phone
- (323) 333-0910
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Registered Respiratory Therapist | 227900000X | |||
| Speech-Language Pathologist | 235Z00000X | |||
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
12441 SE Stark St
Portland, OR 97233-1053
Mailing address
1777 Avenue of the States Ste 102
Lakewood, NJ 08701-4779
Phone (732) 366-8300
Other names 1
- Portland Health & Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231018001197 | OR | Part A Provider - Skilled Nursing Facility | 3870948391 | Practice locations: Portland, OR |
Skilled nursing facility certification: CCN 385228
- Legal name
- PORTLAND SNF OPERATIONS LLC
- Doing business as
- PORTLAND HEALTH & REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1992
- Last certification
- Oct 29, 2024
- Beds
- 105
- Ownership / control type
- Corporation
- Multi-facility organization
- EVERGREEN HEALTH CARE
- Organization structure
- LLC
- Enrollment address
- 12441 SE Stark St
Portland, OR 97233-1053 - Nursing home name
- PORTLAND HEALTH AND REHABILITATION
- Affiliated entity
- EVERGREEN HEALTHCARE GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Portland Health and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1992
- Medicare certification status
- Active
- Certified beds
- 105
- Chain
- Evergreen Healthcare Group
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryLocations
12441 SE Stark St
Portland, OR 97233
Phone (503) 225-7040
Ownership & related parties
All disclosed owners & managing parties 24
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 |
|---|---|---|---|
| Adp of the SNF | Aug 31, 2023 | ||
| Witzcorp Global LLC | 5% Or Greater Indirect Ownership Interest | Aug 31, 2023 | 25% |
| Adp of the SNF | Aug 31, 2023 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 25% | |
| Pacific Northwest SNF Operations Holdings LLC | Indirect Ownership Interest | Aug 31, 2023 | 100% |
| Couve Healthcare Consulting LLC | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Mar 31, 2025 | ||
| Duffy Dezember | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 | ||
| Couve Financial Services LLC | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 2.25% | |
| Indirect Ownership Interest | Aug 31, 2023 | 3% | |
| Portland SNF Operations LLC | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Jun 18, 2025 | ||
| Direct Ownership Interest | Aug 31, 2023 | ||
| Mylene Cepeda | Managing Control - Governing Body | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 | ||
| Pacific Northwest Opco Management LLC | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 2.25% | |
| Indirect Ownership Interest | Aug 31, 2023 | 1% | |
| Yitzchok Yenowitz | Operational/Managerial Control | Aug 31, 2023 | 100% |
| Adp of the SNF | Aug 31, 2023 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 25% | |
| Yisroel E Herzka | Adp of the SNF | Aug 31, 2023 | |
| Indirect Ownership Interest | Aug 31, 2023 | 66.5% | |
| Oregon SNF Consulting LLC (de) | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Pacific Northwest SNF Operations Holdings (Or) LLC | Direct Ownership Interest | Aug 31, 2023 | 100% |
| Christopher R Morris | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 | ||
| Shimon Spielman | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 1% | |
| Jason Odenthal | Operational/Managerial Control | Aug 31, 2023 | |
| Managing Control - Governing Body | Aug 31, 2023 | ||
| Adp of the SNF | Aug 31, 2023 | ||
| CH Pacific Northwest Holdings LLC | 5% Or Greater Indirect Ownership Interest | Aug 31, 2023 | 66.5% |
| Adp of the SNF | Aug 31, 2023 | ||
| Indirect Ownership Interest | Aug 31, 2023 | 66.5% | |
| Indirect Ownership Interest | Aug 31, 2023 | 3% | |
| Basiru Ceesay | Operational/Managerial Control | Aug 31, 2023 | |
| Adp of the SNF | Aug 31, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Beaverton, OR
- NPI 1699960369
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 51
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Hillsboro, OR
- NPI 1861106148
Couve Financial Services LLC, Couve Healthcare Consulting LLC, Oregon SNF Consulting LLC (de), Pacific Northwest Opco Management LLC
-
- Skilled Nursing Facility
- Independence, OR
- NPI 1598479883
CH Pacific Northwest Holdings LLC, Couve Financial Services LLC, Couve Healthcare Consulting LLC, Oregon SNF Consulting LLC (de), Pacific Northwest Opco Management LLC, Witzcorp Global LLC
-
- Skilled Nursing Facility
- La Grande, OR
- NPI 1225742513
Couve Financial Services LLC, Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- Milton Freewater, OR
- NPI 1861106155
Couve Financial Services LLC, Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- The Dalles, OR
- NPI 1013621309
Couve Financial Services LLC, Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- Gresham, OR
- NPI 1396576617
Couve Financial Services LLC, Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- Salem, OR
- NPI 1194439489
CH Pacific Northwest Holdings LLC, Couve Financial Services LLC, Couve Healthcare Consulting LLC, Oregon SNF Consulting LLC (de), Pacific Northwest Opco Management LLC, Witzcorp Global LLC
-
- Skilled Nursing Facility
- Tacoma, WA
- NPI 1033795315
Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- Longview, WA
- NPI 1528772787
CH Pacific Northwest Holdings LLC, Couve Financial Services LLC, Couve Healthcare Consulting LLC, Pacific Northwest Opco Management LLC
-
- Skilled Nursing Facility
- Billings, MT
- NPI 1760196182
CH Pacific Northwest Holdings LLC, Couve Financial Services LLC, Couve Healthcare Consulting LLC, Pacific Northwest Opco Management LLC, Witzcorp Global LLC
-
- Skilled Nursing Facility
- Colville, WA
- NPI 1972217131
Couve Financial Services LLC, Couve Healthcare Consulting LLC
-
- Skilled Nursing Facility
- Auburn, WA
- NPI 1679287841
CH Pacific Northwest Holdings LLC, Couve Financial Services LLC, Couve Healthcare Consulting LLC, Pacific Northwest Opco Management LLC
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Beaverton, OR
- NPI 1518028976
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725494400000",
"number": "1104530492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 AVENUE OF THE STATES STE 102",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014779",
"telephone_number": "732-366-8300",
"fax_number": "732-523-5312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12441 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331053",
"telephone_number": "503-255-7040"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTLAND SNF OPERATIONS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-11",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A",
"authorized_official_last_name": "YENOWITZ",
"authorized_official_first_name": "YITZCHOK",
"authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
"authorized_official_telephone_number": "323-333-0910"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "227900000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Respiratory Therapist, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Portland Health & Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Portland Health & Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Portland, OR
- Portland Rheumatology Clinic LLC
- Portland SE 10948 of Cascadia, LLC
- Portland SE 6003 of Cascadia, LLC
- Portland SE 812 of Cascadia, LLC
- Portland Sex Therapy, LLC
- Portland Specific Chiropractic, LLC
- Portland Spine & Neck Surgery, P.C.
- Portland Spine Center LLC
- Portland Sports Medicine & Spine Physical Therapy Inc.
- Portland State University Center for Student Health and Counseling
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.