NPIMap

Organization Active NPI

St Johns Rehabilitation Hospital and Nursing Center Inc

Doing business as St. Anthony's Rehabilitation Hospital

  • Rehabilitation Hospital
  • Lauderdale Lakes, FL
National Provider Identifier
1124016688
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
FL4478 Issued in FL
Legal business name
ST JOHNS REHABILITATION HOSPITAL AND NURSING CENTER INC
Doing business as
St. Anthony's Rehabilitation Hospital
Practice address
3487 NW 30TH St
Lauderdale Lakes, FL 33311-1103
Phone
(954) 739-6233
Fax
(954) 485-4023
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Jaime Gonzalez
Title
Regional Dir. Hospital Operations
Phone
(954) 739-6233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X FL4478 FL
Rehabilitation Hospital 283X00000X FL4478 FL Primary

Addresses

Primary practice location

3487 NW 30TH St
Lauderdale Lakes, FL 33311-1103

Mailing address

3487 NW 30TH St
Lauderdale Lakes, FL 33311-1103
Phone (954) 739-6233

Other names 1

  • St. Anthony's Rehabilitation Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101019001434 FL Part A Provider - Hospital 8729047147 Practice locations: Lauderdale Lakes, FL

Hospital certification: CCN 103027

Legal name
ST JOHNS REHABILITATION HOSPITAL AND NURSING CENTER INC
Doing business as
ST ANTHONY'S REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Nov 2, 1984
Last certification
Jun 19, 2019
Beds
26
Ownership / control type
Private (not for profit)
Organization structure
OtherNon-profit
Incorporated
Aug 9, 1979 in FL
Enrollment address
3487 N.W. 30TH Street
Lauderdale Lakes, FL 33311-1107
Hospital Rehabilitation Unit
Hospital subgroups
Specialty hospital

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Anthony's Rehabilitation HospitalCCN 103027 · All quality measures
Ownership
Non-profit
Certified
Nov 2, 1984
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
St Johns Nursing Center2 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.

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Catholic Health Services Inc Organization, Lauderdale Lakes, FL Operational/Managerial Control Feb 4, 1986
Archdiocese of Miami Inc Organization, Miami Shores, FL 5% Or Greater Indirect Ownership Interest Aug 9, 1979 100%
Jaime Gonzalez Individual W-2 Managing EmployeeRegional Director Hospital Operatio Sep 17, 2019 100%
Aristides Pallin Individual Contracted Managing EmployeeCeo Oct 1, 2021
Corporate OfficerPresident Oct 1, 2021
St Johns Rehabilitation Hospital and Nursing Center Inc Organization, Lauderdale Lakes, FL 5% Or Greater Direct Ownership Interest Aug 9, 1979 100%
David D'Amico Individual Contracted Managing Employee Aug 1, 2011

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Johns Nursing CenterLauderdale Lakes, FL, CCN 105371 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Aug 9, 1979
Mar 6, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1124016688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3487 NW 30TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111103",
            "telephone_number": "954-739-6233",
            "fax_number": "954-485-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3487 NW 30TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111103",
            "telephone_number": "954-739-6233",
            "fax_number": "954-485-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS REHABILITATION HOSPITAL AND NURSING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "REGIONAL DIR. HOSPITAL OPERATIONS",
        "authorized_official_telephone_number": "954-739-6233"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "FL4478",
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "FL",
            "license": "FL4478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Anthony's Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Anthony's Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.