Organization Active NPI

Vantage at Worcester LLC

  • Skilled Nursing Facility
  • Worcester, MA
National Provider Identifier
1194601930
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
VANTAGE AT WORCESTER LLC
Practice address
59 Acton St
Worcester, MA 01604-4829
Phone
(508) 791-3147
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Sam Yurowitz
Title
Authorized Official
Phone
(845) 558-2685

Specialties & licenses 1

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

Addresses

Primary practice location

59 Acton St
Worcester, MA 01604-4829

Mailing address

59 Acton St
Worcester, MA 01604-4829
Phone (508) 791-3147

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218002023 MA Part A Provider - Skilled Nursing Facility 6901386820 Practice locations: Worcester, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194601930. Details of each certification follow.

Skilled nursing facility certification: CCN 225219

Legal name
VANTAGE AT WORCESTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 18, 1976
Last certification
Nov 19, 2024
Beds
173
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Vantage Care, LLC
Organization structure
LLCProprietary
Enrollment address
59 Acton St
Worcester, MA 01604-4829
Nursing home name
VANTAGE AT WORCESTER LLC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vantage at Worcester LLCCCN 225219 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 18, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
173107.8 residents per day on average
Penalties (3 years)
2Fines totaling $122,646
Ownership change
Changed ownership in the last 12 months

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0069596Vantage Health and Rehab Worcester59 Acton St, Worcester, MA 01604Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Miriam Tehilah Herskovitz Individual 5% Or Greater Direct Ownership Interest Dec 29, 2025 25%
Organization, Lawrence, NY Adp of the SNF Dec 29, 2025
Jeri Ann Johnson Individual Operational/Managerial Control Dec 29, 2025
Managing Control - Governing Body Dec 29, 2025
Adp of the SNF Dec 29, 2025
Vantage Worcester Realty LLC Organization, Worcester, MA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Dec 29, 2025 100%
Adp of the SNF Dec 29, 2025
Organization, Brooklyn, NY LLC Adp of the SNF Jan 20, 2026
LTC Consulting Services LLC Organization, Lakewood, NJ LLC Adp of the SNF Dec 29, 2025
Innovations Healthcare, LLC Organization, Pascoag, RI LLC Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 12, 2025
Jamie Belezarian Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Cheryl Arem Individual 5% Or Greater Direct Ownership Interest Dec 29, 2025 25%
Organization, Brooklyn, NY Adp of the SNF Dec 29, 2025
Im Family Holdings LLC Organization, Brooklyn, NY LLC Adp of the SNF Dec 29, 2025
Organization, Brooklyn, NY Adp of the SNF Dec 29, 2025
Organization, Worcester, MA LLC Adp of the SNF Dec 29, 2025
Jca Capital Associates LLC Organization, Brooklyn, NY LLC Adp of the SNF Dec 29, 2025
Morris Green Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Sam Yurowitz Individual 5% Or Greater Direct Ownership InterestPrincipal Owners Dec 29, 2025 25%
Corporate OfficerPrincipal Owners Dec 29, 2025
Corporate Director Dec 29, 2025
Operational/Managerial Control Dec 29, 2025
Managing Control - Governing BodyPrincipal Owners Dec 29, 2025
Adp of the SNF Dec 29, 2025
Stephanie Jones Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Organization, Lawrence, NY Adp of the SNF Dec 29, 2025
Ajay J Anand Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Jan 20, 2026
Yossi Brown Individual 5% Or Greater Direct Ownership InterestPrincipal Owners Dec 29, 2025 25%
Corporate OfficerPrincipal Owners Dec 29, 2025
Corporate Director Dec 29, 2025
Operational/Managerial Control Dec 29, 2025
Managing Control - Governing BodyPrincipal Owners Dec 29, 2025
Adp of the SNF Dec 29, 2025
Organization, Brooklyn, NY LLC, Holding company Adp of the SNF Dec 29, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1194601930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ACTON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044829",
            "telephone_number": "508-791-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ACTON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044829",
            "telephone_number": "508-791-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE AT WORCESTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "YUROWITZ",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-558-2685"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.