Active NPI
Pine Valley Center LLC
- Skilled Nursing Facility
- Spring Valley, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 207RG0300X
- Legal business name
- PINE VALLEY CENTER LLC
- Practice address
- 661 N Main St
Spring Valley, NY 10977-2319 - Phone
- (845) 426-5600
- Fax
- (845) 352-2704
- NPI assigned
- Sep 29, 2005
- 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
- Mr. Michael Tropper
- Title
- Administrator
- Phone
- (845) 426-5600
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | |||
| Skilled Nursing Facility | 314000000X | 207RG0300X | NY | Primary |
Addresses
Primary practice location
661 N Main St
Spring Valley, NY 10977-2319
Mailing address
661 N Main St
Spring Valley, NY 10977-2319
Phone (845) 426-5600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00311082 | Medicaid | NY |
Other names 1
- Pine Valley Center for Rehabilitation and Nursing
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041221000053 | NY | Part A Provider - Skilled Nursing Facility | 0648238899 | Practice locations: Spring Valley, NY |
Skilled nursing facility certification: CCN 335285
- Legal name
- PINE VALLEY CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 14, 1969
- Last certification
- Jul 14, 2023
- Beds
- 160
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Nov 24, 2004 in NY
- Enrollment address
- 661N Main St
Spring Valley, NY 10977-2319 - Nursing home name
- PINE VALLEY CENTER FOR REHABILITATION AND NURSING
- Affiliated entity
- UPSTATE SERVICES GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pine Valley Center For Rehabilitation And Nursing
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 14, 1969
- Medicare certification status
- Active
- Certified beds
- 160
- Chain
- Upstate Services Group
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 |
|---|---|---|---|
| 33D0885711 | Pine Valley Center for Rehabilitation & Nursing | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Uri Koenig | 5% Or Greater Direct Ownership Interest | Dec 22, 2010 | 22.1% |
| David Camerota | Other | Dec 22, 2010 | 0.1% |
| Neil Koenig | Other | Dec 22, 2010 | 4% |
| Efraim Steif | 5% Or Greater Direct Ownership Interest | Dec 22, 2010 | 49.9% |
| Operational/Managerial Control | Aug 15, 2017 | 49.9% | |
| Amy Wuertzer | Corporate Officer | Sep 14, 2017 | |
| Robert Chambre | Other | Dec 22, 2010 | 2.5% |
| Moshe Koenig | Other | Dec 22, 2010 | 2.3% |
| Lawrence Koenig | 5% Or Greater Direct Ownership Interest | Dec 22, 2010 | 17.1% |
| Jack Augenstein | Corporate Officer | Jan 15, 2015 | |
| Corporate Director | Jan 15, 2015 | ||
| David Koenig | Other | Dec 22, 2010 | 2% |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Pomona, NY
- NPI 1558444802
-
- Internal Medicine Physician
- Spring Valley, NY
- NPI 1265473540
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": "1127952000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698364800000",
"number": "1184611758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 N MAIN ST",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109772319",
"telephone_number": "845-426-5600",
"fax_number": "845-352-2704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "661 N MAIN ST",
"city": "SPRING VALLEY",
"state": "NY",
"postal_code": "109772319",
"telephone_number": "845-426-5600",
"fax_number": "845-352-2704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINE VALLEY CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-29",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A",
"authorized_official_last_name": "TROPPER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "845-426-5600",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "207RG0300X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00311082",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pine Valley Center for Rehabilitation and Nursing",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Pine Valley Center for Rehabilitation and Nursing",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Spring Valley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.