Active NPI
Suffield SNF Operations LLC
- Skilled Nursing Facility
- Suffield, CT
National Provider Identifier
1114784386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SUFFIELD SNF OPERATIONS LLC
- Practice address
- 1 Canal Rd
Suffield, CT 06078-1921 - Phone
- (860) 668-6111
- NPI assigned
- Mar 4, 2024
- 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
- Moshe Gottlieb
- Title
- Authorized Rep
- Phone
- (732) 569-4086
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1 Canal Rd
Suffield, CT 06078-1921
Mailing address
1 Canal Rd
Suffield, CT 06078-1921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240619001587 | CT | Part A Provider - Skilled Nursing Facility | 8123561065 | Practice locations: Suffield, CT |
Skilled nursing facility certification: CCN 075347
- Legal name
- SUFFIELD SNF OPERATIONS LLC
- Doing business as
- SUFFIELD HOUSE REHABILITATION AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 21, 1991
- Last certification
- Jan 9, 2025
- Beds
- 128
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- ATLAS HEALTHCARE GROUP
- Most recent change of ownership
- May 1, 2024
- Organization structure
- LLC
- Enrollment address
- 1 Canal Rd
Suffield, CT 06078-1921 - Nursing home name
- SUFFIELD HOUSE REHABILITATION AND HEALTHCARE CENTE
- Affiliated entity
- ATLAS HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Suffield House Rehabilitation and Healthcare Cente
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 21, 1991
- Medicare certification status
- Active
- Certified beds
- 128
- Chain
- Atlas Healthcare
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Suffield SNF Operations Holdings LLC | 5% Or Greater Direct Ownership Interest | May 1, 2024 | 100% |
| HB Suffield Holdings LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2024 | 7.5% |
| Moshe Gottlieb | 5% Or Greater Indirect Ownership Interest | May 1, 2024 | 77.5% |
| Corporate Officer | May 1, 2024 | ||
| LS Suffield Holdings LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2024 | 7.5% |
| SG Suffield Holdings LLC | 5% Or Greater Indirect Ownership Interest | May 1, 2024 | 7.5% |
| Carrie Riccio | W-2 Managing Employee | May 1, 2024 | |
| Dushyant Parikh | Contracted Managing Employee | May 1, 2024 |
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
- Enfield, CT
- NPI 1023033008
Contracted Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1709510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709510400000",
"number": "1114784386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CANAL RD",
"city": "SUFFIELD",
"state": "CT",
"postal_code": "060781921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CANAL RD",
"city": "SUFFIELD",
"state": "CT",
"postal_code": "060781921",
"telephone_number": "860-668-6111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUFFIELD SNF OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-04",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A",
"authorized_official_last_name": "GOTTLIEB",
"authorized_official_first_name": "MOSHE",
"authorized_official_title_or_position": "AUTHORIZED REP",
"authorized_official_telephone_number": "732-569-4086"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suffield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.