Pinnacle Group of Hudson Valley IV LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PINNACLE GROUP OF HUDSON VALLEY IV LLC

Doing business as

Pinnacle Health & Rehab at South Portland

Practice address

42 Anthoine St
S Portland, ME 04106-4403

Phone

(207) 799-8561

NPI assigned

Jul 11, 2019

Last updated

Oct 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Israel Nachfolger, RN, NREMTP

Title

Ceo

Phone

(845) 596-6633

Specialties & licenses 2

Addresses

Other names 1

• Pinnacle Health & Rehab at South Portland Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154973063. Details of each certification follow.

• CCN 205121 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 205121

Legal name

PINNACLE GROUP OF HUDSON VALLEY IV LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1993

Last certification

Dec 8, 2022

Beds

73

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Pinnacle of Hudson Valley, LLC

Organization structure

LLCProprietary

Incorporated

Jul 8, 2019 in ME

Enrollment address

42 Anthoine St
South Portland, ME 04106-4403

Nursing home name

PINNACLE HEALTH & REHAB AT SOUTH PORTLAND

Listed as

Pinnacle Health & Rehab at South PortlandCCN 205121 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7366.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

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.

• Ari S Berman, MD

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1225015829

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ari S Berman, MD

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1225015829
  NPD (past)
• Kirsten Berman, M.D.

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1043280431
  NPD (past)
• Bobby A Malik, MD

  • Internal Medicine Physician
  • Stratford, CT
  • NPI 1396804712
  NPD (past)
• Kelli B Mayfield, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Concord, NC
  • NPI 1598743114
  NPD (past)

Affiliated clinicians 1

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

• Kelli B Mayfield, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Concord, NC
  • NPI 1598743114

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1154973063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VILLA LN",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521021",
            "telephone_number": "845-596-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 ANTHOINE ST",
            "city": "S PORTLAND",
            "state": "ME",
            "postal_code": "041064403",
            "telephone_number": "207-799-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE GROUP OF HUDSON VALLEY IV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "NACHFOLGER",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "845-596-6633",
        "authorized_official_credential": "RN, NREMTP"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Health & Rehab at South Portland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pinnacle Health & Rehab at South Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in S Portland, ME
• Providers in S Portland, ME by specialty
• Skilled Nursing Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.