Vacaville Healthcare Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

110000203 Issued in CA

Legal business name

VACAVILLE HEALTHCARE INC

Practice address

585 Nut Tree CT
Vacaville, CA 95687-3353

Phone

(707) 449-8000

Fax

(707) 449-4166

NPI assigned

Oct 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Martin Niccoli Jr.

Title

Administrator

Phone

(707) 449-8000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vacaville Convalescent & Rehabilitation Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Skilled nursing facility certification: CCN 555349

Legal name

VACAVILLE HEALTHCARE INC

Doing business as

VACAVILLE CONVALESCENT & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 20, 1989

Last certification

Dec 6, 2024

Beds

120

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

May 16, 2003 in CA

Enrollment address

585 Nut Tree CT
Vacaville, CA 95687-3353

Nursing home name

VACAVILLE CONVALESCENT AND REHABILITATION CENTER

Listed as

Vacaville Convalescent and Rehabilitation CenterCCN 555349

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Apr 20, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12092.9 residents per day on average

Penalties (3 years)

1Fines totaling $7,976

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 10

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.

• Terrell B. Van Aken, M.D.

  • Family Medicine Physician
  • Vacaville, CA
  • NPI 1306941430

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 6

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

• Kathryn Amacher, DO

  • Geriatric Medicine (Internal Medicine) Physician
  • Vacaville, CA
  • NPI 1366545568

  Nursing home

  Care Compare affiliation
• Gaurav Datta, MD

  • Internal Medicine Physician
  • Elk Grove, CA
  • NPI 1225184765

  Nursing home

  Care Compare affiliation
• Jau Dean Lee, M.D.

  • Family Medicine Physician
  • Vacaville, CA
  • NPI 1508953886

  Nursing home

  Care Compare affiliation
• Michael L Richardson Jr., M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Vacaville, CA
  • NPI 1831327899

  Nursing home

  Care Compare affiliation
• Gautam K Vadlamudi, M.D.

  • Family Medicine Physician
  • Vacaville, CA
  • NPI 1184729212

  Nursing home

  Care Compare affiliation
• Terrell B. Van Aken, M.D.

  • Family Medicine Physician
  • Vacaville, CA
  • NPI 1306941430

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1114914355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 NUT TREE CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873353",
            "telephone_number": "707-449-8000",
            "fax_number": "707-449-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 NUT TREE CT",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873353",
            "telephone_number": "707-449-8000",
            "fax_number": "707-449-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VACAVILLE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "NICCOLI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-449-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "110000203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55349I",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/",
            "affiliation": "N",
            "endpointDescription": "16.840.1.113883.3.667.2",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMDM-M eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Vacaville Convalescent & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vaca Valley Chiropractic David Lamb DC Sean Moffett DC Inc
• Vaca Valley Speech Therapy, PC
• Vacaville Dental Professionals
• Vacaville Imaging Center Medical
• Vacaville Music Therapy
• Vacaville Optometric Vision Center Inc.
• Vacaville Police Department
• Vacaville Senior Assisted Living

• Skilled Nursing Facility in Vacaville, CA
• Providers in Vacaville, 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 Jan 8, 2026; 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.