Organization Active NPI

North Port Rehab, LLC

  • Skilled Nursing Facility
  • North Port, FL
National Provider Identifier
1164083176
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
NORTH PORT REHAB, LLC
Practice address
6940 Outreach Way
North Port, FL 34287-3405
Phone
(941) 426-8411
NPI assigned
Jun 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Samuel Gutman
Title
Authorized Signer
Phone
(718) 852-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6940 Outreach Way
North Port, FL 34287-3405

Mailing address

1000 Gates Ave
Brooklyn, NY 11221-6295
Phone (718) 852-7000

Other names 1

  • North Port Rehabilitation and Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190807001119 FL Part A Provider - Skilled Nursing Facility 0244567782 Practice locations: North Port, FL

Skilled nursing facility certification: CCN 105523

Legal name
NORTH PORT REHAB, LLC
Doing business as
NORTH PORT REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1986
Last certification
Jul 18, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Dec 3, 2018 in FL
Enrollment address
6940 Outreach Way
North Port, FL 34287-3405
Nursing home name
NORTH PORT REHABILITATION AND NURSING CENTER
Affiliated entity
ASTON HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
North Port Rehabilitation and Nursing CenterCCN 105523
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120116.6 residents per day on average
Chain
Aston Health38 facilities in the chain
Penalties (3 years)
1Fines totaling $14,770

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
10D0296362North Port Rehabilitation and Nursing Center6940 Outreach Way, North Port, FL 34287Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Networks

  • 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)
  • 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)…

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
NP Rehab Holdings LLC Organization, Brooklyn, NY Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 3, 2018 100%
Rachel Koch Individual Operational/Managerial Control Feb 18, 2025
Aston Healthcare LLC Organization, Brooklyn, NY LLC, Consulting firm, For-profit Adp of the SNF Jan 1, 2022
Organization, Brooklyn, NY LLC, For-profit Adp of the SNF Aug 25, 2025
Donna Wildes Individual Corporate OfficerCeo Aug 28, 2025
Operational/Managerial Control Aug 28, 2025
Adp of the SNF Aug 28, 2025
Organization, Brooklyn, NY LLC, Consulting firm, For-profit Adp of the SNF Aug 25, 2025
Organization, Skokie, IL LLC, Holding company, For-profit Adp of the SNF Sep 16, 2025
Herman Gleicher Individual Operational/Managerial Control Jan 3, 2022
Adp of the SNF Oct 15, 2025
Quality Rehab Partners LLC Organization, Brooklyn, NY Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 3, 2018 100%
Samuel Gutman Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2019 48.51%
Alexis Domonique Villegas Individual Operational/Managerial Control May 13, 2024
Adp of the SNF Oct 15, 2025
Leopold Friedman Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2019 51%
Individual Indirect Ownership Interest Aug 1, 2019 0.49%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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": "1561075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1164083176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GATES AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112216295",
            "telephone_number": "718-852-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 OUTREACH WAY",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342873405",
            "telephone_number": "941-426-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PORT REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-21",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "GUTMAN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "718-852-7000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Port Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.