NPIMap

Organization Active NPI

The Ponce Therapy Care Center and Rehab LLC

  • Skilled Nursing Facility
  • St Augustine, FL
National Provider Identifier
1154071561
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE PONCE THERAPY CARE CENTER AND REHAB LLC
Practice address
1999 Old Moultrie Rd
St Augustine, FL 32086-5164
Phone
(904) 824-3311
NPI assigned
Mar 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 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

1999 Old Moultrie Rd
St Augustine, FL 32086-5164

Mailing address

1999 Old Moultrie Rd
St Augustine, FL 32086-5164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221108002518 FL Part A Provider - Skilled Nursing Facility 7416324223 Practice locations: Saint Augustine, FL

Skilled nursing facility certification: CCN 105468

Legal name
THE PONCE THERAPY CARE CENTER AND REHAB LLC
Doing business as
THE PONCE THERAPY CARE CENTER AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 3, 1984
Last certification
Oct 26, 2023
Beds
120
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jul 27, 2022 in FL
Enrollment address
1999 Old Moultrie Rd
Saint Augustine, FL 32086-5164
Nursing home name
PONCE THERAPY CARE CENTER AND REHAB, THE
Affiliated entity
GOLD FL TRUST II

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ponce Therapy Care Center and Rehab, theCCN 105468
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 3, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120116.0 residents per day on average
Chain
Gold FL Trust II36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0868727Ponce Therapy Care Center and Rehab LLC, the1999 Old Moultrie Rd, Saint Augustine, FL 32086Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Networks

  • 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
The Ponce SNF Holdco LLC Organization, Montebello, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 23, 2022 100%
Copper FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022
Jack Y Shelby Individual Corporate Officer Jul 27, 2022 100%
John Devaul 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 24, 2022 100%
Gold FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%

Facilities with the same owner 34

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

View all 34

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1154071561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 OLD MOULTRIE RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 OLD MOULTRIE RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865164",
            "telephone_number": "904-824-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PONCE THERAPY CARE CENTER AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "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 St Augustine, FL

Sources for this page

Verify at the official NPI Registry.