Ensign Montgomery LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

010000062 Issued in CA

Legal business name

ENSIGN MONTGOMERY LLC

Practice address

3751 Montgomery Dr
Santa Rosa, CA 95405-5214

Phone

(707) 525-1250

Fax

(707) 525-1080

NPI assigned

Jul 18, 2005

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Treasurer

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park View Post Acute Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Skilled nursing facility certification: CCN 056411

Legal name

ENSIGN MONTGOMERY LLC

Doing business as

PARK VIEW POST ACUTE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 1, 1975

Last certification

May 17, 2024

Beds

116

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Ensign Services, Inc.

Organization structure

LLCProprietary

Incorporated

Aug 31, 2000 in NV

Enrollment address

3751 Montgomery Dr
Santa Rosa, CA 95405-5214

Nursing home name

PARK VIEW POST ACUTE

Affiliated entity

THE ENSIGN GROUP

Listed as

Park View Post AcuteCCN 056411

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Feb 1, 1975

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

116106.3 residents per day on average

Chain

The Ensign Group342 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $9,347

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 13

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

Owners & managing parties with NPI records 1

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

• Aynna Y. Sae, MD

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1598898942

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 2

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

• West Court Lane Healthcare, Inc.

  • Skilled Nursing Facility
  • Davis, CA
  • NPI 1215759865

  Jackson Therapy Partners LLC

  CMS ownership
• Sawtooth Healthcare, Inc.

  • Skilled Nursing Facility
  • Salmon, ID
  • NPI 1477816965

  Jackson Therapy Partners LLC

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Aynna Y. Sae, MD

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1598898942

  Nursing home

  Care Compare affiliation
• Michael Sungwon Yoo, M.D.

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1669640934

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1104825520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055214",
            "telephone_number": "707-525-1250",
            "fax_number": "707-525-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055214",
            "telephone_number": "707-525-1250",
            "fax_number": "707-525-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENSIGN MONTGOMERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "010000062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR06411I",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Park View Post Acute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Park View Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexander Joachim Engelmann, PHARMD
• Brittany English, FNP
• Candace Jean English, MFT
• Garrett Ennis
• Patrick S Ennis, LCSW
• Ensign Santa Rosa LLC
• Patricia L. Ensrud
• Entegrative Otolaryngology PC
• Eos Eyecare Optometric Group
• Hannah Ercolini

• Skilled Nursing Facility in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.

Verify at the official NPI Registry.