Pines Village, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

656000 Issued in NJ

Legal business name

PINES VILLAGE, INC.

Practice address

509 Route 530
Whiting, NJ 08759-3145

Phone

(732) 849-0400

Fax

(732) 350-0540

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Brenden Garozzo

Title

Executive Director

Phone

(732) 849-0400

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104992528. Details of each certification follow.

• CCN 315347 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 315347

Legal name

KESWICK PINES INC

Doing business as

THE PINES AT WHITING

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 28, 1995

Last certification

Apr 26, 2024

Beds

66

Ownership / control type

Nonprofit Corporation

Most recent change of ownership

Jul 31, 2023

Organization structure

CorporationNon-profit

Incorporated

Jan 31, 1989 in NJ

Enrollment address

509 Route 530
Whiting, NJ 08759-3145

Nursing home name

SKILLED NURSING AT PINE VILLAGE

Listed as

Skilled Nursing at Pine VillageCCN 315347 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Aug 28, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6641.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Keswick Pines Inc2 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.

• Pines Village, Inc.

  dba The Pines at Whiting

  • Assisted Living Facility
  • Whiting, NJ
  • NPI 1184008237
  NPD tax ID

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.

Affiliated clinicians 2

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

• Farida Hassan, M.D

  • Internal Medicine Physician
  • Jackson, NJ
  • NPI 1962677583

  Nursing home

  Care Compare affiliation
• Jay Andrew Vida, DO

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1831195601

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1104992528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 ROUTE 530",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087593145",
            "telephone_number": "732-849-0400",
            "fax_number": "732-350-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ROUTE 530",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087593145",
            "telephone_number": "732-849-0400",
            "fax_number": "732-350-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINES VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "GAROZZO",
        "authorized_official_first_name": "BRENDEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-849-0400"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "65A001",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "656000",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7225008",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ASSISTED",
            "identifier": "7225016",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elise Pavlick, DPT
• Gene L Payumo, M.D.
• Barry R Perlman, DMD
• Hillary Petetti
• Mary Kathleen Pettrow, BA
• Pines Village, Inc. (The Pines at Whiting)
• Dominic Pisano, DMD
• Tina Marie Pryor, PMHNP-BC
• Rajshil LLC (Medicine Shoppe)
• Adrian Reyes Ramos, FNP-C

• Skilled Nursing Facility in Whiting, NJ
• Providers in Whiting, NJ by specialty
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.