NPIMap

Organization Active NPI

Brandon Health Opco, LLC

Doing business as Brandon Center for Nursing & Rehabilitation

  • Skilled Nursing Facility
  • Brandon, FL
National Provider Identifier
1194477661
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BRANDON HEALTH OPCO, LLC
Doing business as
Brandon Center for Nursing & Rehabilitation
Victoria Crossing Rehabilitation Center
Practice address
701 Victoria St
Brandon, FL 33510-4100
Phone
(813) 681-4220
Fax
(813) 689-5685
NPI assigned
Jan 25, 2022
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Authorized official

Name
Mathew Varghese
Title
Member
Phone
(917) 817-3530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

701 Victoria St
Brandon, FL 33510-4100

Mailing address

701 Victoria St
Brandon, FL 33510-4100
Phone (813) 681-4220

Other identifiers 1

IdentifierTypeStateIssuer
1577096OtherFLLICENSE

Other names 2

  • Brandon Center for Nursing & Rehabilitation Doing business as
  • VICTORIA CROSSING REHABILITATION CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Brandon Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230901001001 FL Part A Provider - Skilled Nursing Facility 9537522925 Practice locations: Brandon, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194477661. Details of each certification follow.

Skilled nursing facility certification: CCN 106155

Legal name
BRANDON HEALTH OPCO LLC
Doing business as
BRANDON CENTER FOR NURSING & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 7, 2024
Last certification
Feb 7, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Excelcior
Organization structure
LLCProprietary
Incorporated
Jan 19, 2022 in DE
Enrollment address
701 Victoria St
Brandon, FL 33510-4100
Nursing home name
VICTORIA CROSSING REHABILITATION CENTER
Affiliated entity
EXCELSIOR CARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Victoria Crossing Rehabilitation CenterCCN 106155 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 7, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120114.5 residents per day on average
Chain
Excelsior Care Group33 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

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
Joseph Orgel Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 10.19%
Brandon Health Member LLC Organization, Brandon, FL Created for acquisition, LLC, Holding company 5% Or Greater Direct Ownership Interest Apr 1, 2022 100%
Marton Ornstein Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 25.49%
Kimberly D Lucadano Individual W-2 Managing EmployeeAdministrator Apr 1, 2022 100%
Richard Platschek Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 5.5%
Joel Zupnick Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 25.49%
Benjamin Landa Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 33%
Flnho Capital Group LLC Organization, Lawrence, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2022 33.33%

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1194477661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 VICTORIA ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104100",
            "telephone_number": "813-681-4220",
            "fax_number": "813-689-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 VICTORIA ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104100",
            "telephone_number": "813-681-4220",
            "fax_number": "813-689-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON HEALTH OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-817-3530"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1577096",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brandon",
            "affiliation": "N",
            "endpointDescription": "Brandon Health OpCo, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "701 Victoria St",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335104100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brandon Center for Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VICTORIA CROSSING REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.