Active NPI
North Port Rehab, LLC
- Skilled Nursing Facility
- North Port, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1986
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Aston Health
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0296362 | North Port Rehabilitation and Nursing Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
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.
| Name | Role | Since | Share |
|---|---|---|---|
| NP Rehab Holdings LLC | 5% Or Greater Direct Ownership Interest | Dec 3, 2018 | 100% |
| Rachel Koch | Operational/Managerial Control | Feb 18, 2025 | |
| Aston Healthcare LLC | Adp of the SNF | Jan 1, 2022 | |
| Adp of the SNF | Aug 25, 2025 | ||
| Donna Wildes | Corporate Officer | Aug 28, 2025 | |
| Operational/Managerial Control | Aug 28, 2025 | ||
| Adp of the SNF | Aug 28, 2025 | ||
| Adp of the SNF | Aug 25, 2025 | ||
| Adp of the SNF | Sep 16, 2025 | ||
| Herman Gleicher | Operational/Managerial Control | Jan 3, 2022 | |
| Adp of the SNF | Oct 15, 2025 | ||
| Quality Rehab Partners LLC | 5% Or Greater Indirect Ownership Interest | Dec 3, 2018 | 100% |
| Samuel Gutman | 5% Or Greater Indirect Ownership Interest | Aug 1, 2019 | 48.51% |
| Alexis Domonique Villegas | Operational/Managerial Control | May 13, 2024 | |
| Adp of the SNF | Oct 15, 2025 | ||
| Leopold Friedman | 5% Or Greater Indirect Ownership Interest | Aug 1, 2019 | 51% |
| 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.
-
- Internal Medicine Physician
- Port Charlotte, FL
- NPI 1578550273
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Fernandina Beach, FL
- NPI 1073174082
Quality Rehab Partners LLC
-
- Skilled Nursing Facility
- Haines City, FL
- NPI 1518528520
Quality Rehab Partners LLC
-
- Skilled Nursing Facility
- Winter Garden, FL
- NPI 1790346708
Quality Rehab Partners LLC
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
- North Port Pharmacy Inc
- North Port Pines Retirement Centers, Inc.
- North Port Podiatry Center PA
- North Port Podiatry Center PA
- North Port Primary Care Association PL
- North Port Retirement Center, Inc.
- North Port Smiles LLC
- North Port Womens Care LLC
- Northern Medical and Holistic Center Corp
- Northern Medical Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.