NPIMap

Organization Active NPI

Kendall Lakes Healthcare and Rehab Center LLC

  • Skilled Nursing Facility
  • Miami, FL
National Provider Identifier
1124777669
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KENDALL LAKES HEALTHCARE AND REHAB CENTER LLC
Practice address
5280 SW 157TH Ave
Miami, FL 33185-5297
Phone
(786) 433-7400
NPI assigned
Mar 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Moshe Scheiner
Title
Authorized Official
Phone
(845) 490-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5280 SW 157TH Ave
Miami, FL 33185-5297

Mailing address

5280 SW 157TH Ave
Miami, FL 33185-5297

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220831000049 FL Part A Provider - Skilled Nursing Facility 7113301771 Practice locations: Miami, FL

Skilled nursing facility certification: CCN 686123

Legal name
KENDALL LAKES HEALTHCARE AND REHAB CENTER, LLC
Doing business as
KENDALL LAKES HEALTHCARE AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 29, 2019
Last certification
Apr 18, 2024
Beds
150
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jul 27, 2022 in FL
Enrollment address
5280 SW 157TH Ave
Miami, FL 33185-5297
Nursing home name
KENDALL LAKES HEALTHCARE AND REHAB CENTER
Affiliated entity
GOLD FL TRUST II

National Provider Directory

National Provider Directory

Locations

5280 SW 157th Ave
Miami, FL 33185
Phone (305) 220-3592

Networks

  • HealthSun Health Plans Network
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & 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.

NameRoleSinceShare
Silver FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%
Copper FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 10%
Jack Y Shelby Individual Corporate Officer Jul 27, 2022 100%
Leyla Marin Individual W-2 Managing EmployeeAdministrator Jul 27, 2022 100%
FL Master Opco Holdco LLC Organization, Miami, FL Created for acquisition, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 27, 2022 100%
Gold FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%
Kendall Lakes SNF Holdco LLC Organization, Montebello, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 23, 2022 100%

Facilities with the same owner 34

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

View all 34

Affiliated clinicians 11

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Kendall Lakes Healthcare and Rehab CenterCCN 686123
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 29, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
150142.3 residents per day on average
Chain
Gold FL Trust II36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1124777669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5280 SW 157TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5280 SW 157TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855297",
            "telephone_number": "786-433-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL LAKES HEALTHCARE AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "SCHEINER",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-490-6060"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.