Active NPI
Hawthorne Brandon SNF Operations LLC
Doing business as Hawthorne Center for Rehabilitation & Healing of Brandon
- Skilled Nursing Facility
- Brandon, FL
National Provider Identifier
1205416351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- HAWTHORNE BRANDON SNF OPERATIONS LLC
- Doing business as
- Hawthorne Center for Rehabilitation & Healing of Brandon
- Practice address
- 851 W Lumsden Rd
Brandon, FL 33511-6280 - Phone
- (813) 661-8998
- NPI assigned
- Apr 13, 2021
- 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
- Solomon Klein
- Title
- Member
- Phone
- (347) 909-1811
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
851 W Lumsden Rd
Brandon, FL 33511-6280
Mailing address
851 W Lumsden Rd
Brandon, FL 33511-6280
Other names 1
- Hawthorne Center for Rehabilitation & Healing of Brandon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210929003492 | FL | Part A Provider - Skilled Nursing Facility | 9133526338 | Practice locations: Brandon, FL |
Skilled nursing facility certification: CCN 105881
- Legal name
- HAWTHORNE BRANDON SNF OPERATIONS LLC
- Doing business as
- HAWTHORNE CENTER FOR REHABILITATION AND HEALING OF BRANDON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 27, 1995
- Last certification
- Mar 13, 2024
- Beds
- 132
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Mar 24, 2021 in DE
- Enrollment address
- 851 W Lumsden Rd
Brandon, FL 33511-6280 - Nursing home name
- HAWTHORNE CENTER FOR REHABILITATION AND HEALING OF
- Affiliated entity
- SUMMIT CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Hawthorne Center for Rehabilitation and Healing of
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 27, 1995
- Medicare certification status
- Active
- Certified beds
- 132
- Chain
- Summit Care
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 |
|---|---|---|---|
| 10D0898080 | Hawthorne Center for Rehabilitation & Healing of | Certificate of waiver | Feb 21, 2027 |
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Solomon Klein | 5% Or Greater Indirect Ownership Interest | Aug 4, 2021 | 100% |
| Shaul Kopelowitz | 5% Or Greater Indirect Ownership Interest | Aug 4, 2021 | 14.4% |
| Hawthorne Brandon SNF Operations Holdings LLC | 5% Or Greater Direct Ownership Interest | Mar 31, 2021 | 100% |
| Chava Wolofsky | 5% Or Greater Indirect Ownership Interest | Aug 4, 2021 | 17.5% |
| Hawthorne Care Management LLC | Operational/Managerial Control | Aug 4, 2021 | 100% |
| Yisroel E Herzka | 5% Or Greater Indirect Ownership Interest | Aug 4, 2021 | 17.5% |
| Susan V Stanton | W-2 Managing Employee | Aug 4, 2021 |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Ocala, FL
- NPI 1841881323
Hawthorne Care Management LLC
-
dba Hawthorne Center for Rehabilitation & Healing of Sarasota
- Skilled Nursing Facility
- Sarasota, FL
- NPI 1568042620
Hawthorne Care Management LLC
Practitioners & affiliated clinicians
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Tampa, FL
- NPI 1477723781
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Tampa, FL
- NPI 1558395574
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1618272000000",
"number": "1205416351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "851 W LUMSDEN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "851 W LUMSDEN RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335116280",
"telephone_number": "813-661-8998"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAWTHORNE BRANDON SNF OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-13",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A",
"authorized_official_last_name": "KLEIN",
"authorized_official_first_name": "SOLOMON",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "347-909-1811"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hawthorne Center for Rehabilitation & Healing of Brandon",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.