Berkshire Nursing Home, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BERKSHIRE NURSING HOME, LLC

Practice address

10 Berkshire Rd
West Babylon, NY 11704-6609

Phone

(631) 587-0600

Fax

(631) 587-0053

NPI assigned

Oct 20, 2005

Last updated

Aug 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joel Edelstein

Title

Manager

Phone

(718) 888-5206

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194714345. Details of each certification follow.

• CCN 335083001 Skilled nursing facility · Details

Skilled nursing facility certification: CCN 335083001

Legal name

BERKSHIRE NURSING HOME LLC

Organization structure

LLCProprietary

Incorporated

Mar 1, 2001 in NY

Enrollment address

10 Berkshire Rd
West Babylon, NY 11704-6609

Nursing home name

BERKSHIRE NURSING & REHABILITATION CENTER

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

CLIA laboratory certificates

All disclosed owners & managing parties 9

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

Owners & managing parties with NPI records 1

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

• Charles L Knoll, MD

  • Urology Physician
  • New York, NY
  • NPI 1932123486

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 8

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.

• Barry Hal Balot, DO

  • Internal Medicine Physician
  • Lindenhurst, NY
  • NPI 1215997887
  NPD (past)
• Abu Muhammad M Haque, MD

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1588658512
  NPD (past)
• Adeel Azmat Iqbal, D.O.

  • Internal Medicine Physician
  • Patchogue, NY
  • NPI 1780996983
  NPD (past)
• Charles L Knoll, MD

  • Urology Physician
  • New York, NY
  • NPI 1932123486
  NPD (past)
• Khalid A Noori, M.D.

  • Internal Medicine Physician
  • North Babylon, NY
  • NPI 1023106838
  NPD (past)
• Pulat Pulatov

  • Family Medicine Physician
  • Glendale, NY
  • NPI 1437579166
  NPD (past)
• Anthony Joseph Rizzo, DO

  • Family Medicine Physician
  • Bay Shore, NY
  • NPI 1194736470
  NPD (past)
• Masood Saeed, M.D.

  • Hospitalist Physician
  • Plainview, NY
  • NPI 1588921894
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1194714345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BERKSHIRE RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046609",
            "telephone_number": "631-587-0600",
            "fax_number": "631-587-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BERKSHIRE RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117046609",
            "telephone_number": "631-587-0600",
            "fax_number": "631-587-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKSHIRE NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-888-5206"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02097230",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dolores J Bellissimo, LMSW
• Robert Fred Bello, D.P.M.
• Maria Joyce Lanuzo Belza
• Jessica May Bendernagel, LMSW
• Marlene Bennett
• Michael F Bernstein, D.C.
• Beyond Wellness Massage Therapy and Acupuncture P.C.
• Melissa Bezzina
• Roslyn W Block, LCSW
• Jennifer Susan Bloodnick, B.S.

• Skilled Nursing Facility in West Babylon, NY
• Providers in West Babylon, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.

Verify at the official NPI Registry.