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Organization Active NPI

Fort Tryon Rehabilitation & Health Care Facility LLC

  • Skilled Nursing Facility
  • New York, NY
National Provider Identifier
1184797342
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7002359N Issued in NY
Legal business name
FORT TRYON REHABILITATION & HEALTH CARE FACILITY LLC
Practice address
801 W 190TH St
New York, NY 10040
Phone
(212) 543-6400
Fax
(212) 543-6419
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Mr. Michael Karash, CNHA
Title
Administrator
Phone
(212) 543-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7002359N NY Primary

Addresses

Primary practice location

801 W 190TH St
New York, NY 10040

Mailing address

801 W 190TH St
New York, NY 10040-3802
Phone (212) 543-6400

Other identifiers 2

IdentifierTypeStateIssuer
00310256MedicaidNY
7002359NOtherNYOPERATING CERTIFICATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090601000104 NY Part A Provider - Skilled Nursing Facility 4486563335 Practice locations: New York, NY

Skilled nursing facility certification: CCN 335257001

Legal name
FORT TRYON REHABILITATION & HEALTH CARE FACILITY LLC
Organization structure
LLCProprietary
Incorporated
Jul 23, 2002 in NY
Enrollment address
801W 190TH St
New York, NY 10040-3802
Nursing home name
FORT TRYON CENTER FOR REHABILITATION AND NURSING

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Fort Tryon Rehabilitation Health Care Facility LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Aharon Weiss Individual Corporate OfficerFinance Jan 1, 2012 10%
Boruch Webster Individual Limited Partnership InterestMember Jan 1, 2009 2%
Shelly Nakdimen Individual 5% Or Greater Direct Ownership InterestMember Nov 1, 2002 5%
Yecheskel Webster Individual Limited Partnership InterestMember Jan 1, 2009 2%
Ben Webster Individual Limited Partnership InterestMember Jan 1, 2009 2%
Helen Webster Individual 5% Or Greater Direct Ownership InterestManaging Member Nov 1, 2002 86.5%
Corporate Director Jan 1, 2009
W-2 Managing Employee Jan 1, 2009
Moshe Webster Individual Limited Partnership InterestMember Jan 1, 2009 2.5%
Corporate Director Jan 1, 2009
Michael Karash Individual Corporate DirectorAdministrator Mar 13, 2011 100%

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1184797342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W 190TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403802",
            "telephone_number": "212-543-6400",
            "fax_number": "212-543-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 190TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10040",
            "telephone_number": "212-543-6400",
            "fax_number": "212-543-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT TRYON REHABILITATION & HEALTH CARE FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "KARASH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "212-543-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7002359N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310256",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPERATING CERTIFICATE",
            "identifier": "7002359N",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.