NPIMap

Organization Active NPI

Shaker Gardens Opco LLC

  • Skilled Nursing Facility
  • Shaker Heights, OH
National Provider Identifier
1174027619
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SHAKER GARDENS OPCO LLC
Practice address
3550 Northfield Rd
Shaker Heights, OH 44122-5253
Phone
(216) 752-5600
NPI assigned
Mar 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Authorized official

Name
Abba Stein
Title
Manager
Phone
(347) 272-4167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3550 Northfield Rd
Shaker Heights, OH 44122-5253

Mailing address

802 Frisco Ave
Far Rockaway, NY 11691-5257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180806002214 OH Part A Provider - Skilled Nursing Facility 1557619624 Practice locations: Shaker Heights, OH

Skilled nursing facility certification: CCN 366021

Legal name
SHAKER GARDENS OPCO LLC
Doing business as
SHAKER GARDENS NURSING AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 11, 1995
Last certification
Oct 17, 2024
Beds
50
Ownership / control type
Corporation
Multi-facility organization
Lionstone
Most recent change of ownership
May 16, 2018
Organization structure
LLCProprietary
Incorporated
Feb 12, 2018 in OH
Enrollment address
3550 Northfield Rd
Shaker Heights, OH 44122
Nursing home name
SHAKER GARDENS NURSING AND REHABILITATION CENTER
Affiliated entity
LIONSTONE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shaker Gardens Nursing and Rehabilitation CenterCCN 366021
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 11, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5045.4 residents per day on average
Chain
Lionstone Care24 facilities in the chain
Penalties (3 years)
4Fines totaling $18,306

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Shaker Gardens Opco LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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
Individual Adp of the SNF Apr 5, 2024
Solomon Kazarnovsky Individual 5% Or Greater Direct Ownership InterestManaging Partner Feb 12, 2018 50%
Operational/Managerial Control May 16, 2018
Adp of the SNF May 16, 2018
Eliezer Goldish Individual Corporate OfficerChief Financial Officer Oct 9, 2023
Operational/Managerial Control Oct 9, 2023
Adp of the SNF Oct 9, 2023
Adam Cusner Individual Corporate OfficerChief Executive Officer Jan 27, 2025
Operational/Managerial Control Jan 27, 2025
Adp of the SNF Jan 27, 2025
Jeffrey Degyansky Individual Corporate OfficerChief Operating Officer Jan 1, 2020
Operational/Managerial Control Jan 1, 2020
Adp of the SNF Jan 1, 2020
Abba Stein Individual 5% Or Greater Direct Ownership InterestManaging Partner Feb 12, 2018 50%
Operational/Managerial Control May 16, 2018
Adp of the SNF May 16, 2018
Individual Adp of the SNF Apr 1, 2022

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1174027619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 FRISCO AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 NORTHFIELD RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225253",
            "telephone_number": "216-752-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKER GARDENS OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "ABBA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-272-4167"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.