NPIMap

Organization Active NPI

Pottsville SNF Operations LLC

  • Skilled Nursing Facility
  • Pottsville, PA
National Provider Identifier
1215761879
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
POTTSVILLE SNF OPERATIONS LLC
Practice address
420 Pulaski Dr
Pottsville, PA 17901-3634
Phone
(773) 825-3336
NPI assigned
Aug 27, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Max Stesel
Title
Manager
Phone
(773) 825-3336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

420 Pulaski Dr
Pottsville, PA 17901-3634

Mailing address

8170 McCormick Blvd Ste 112
Skokie, IL 60076-2914
Phone (773) 825-3336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251030002522 PA Part A Provider - Skilled Nursing Facility 8224527197 Practice locations: Pottsville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215761879. Details of each certification follow.

Skilled nursing facility certification: CCN 395344

Legal name
POTTSVILLE SNF OPERATIONS, LLC
Doing business as
EDENBROOK OF GREENWOOD HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1978
Last certification
Nov 1, 2024
Beds
160
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Eden East
Organization structure
LLC
Enrollment address
420 Pulaski Dr
Pottsville, PA 17901-3634
Nursing home name
EDENBROOK OF GREENWOOD HILL

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edenbrook of Greenwood HillCCN 395344 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
160113.6 residents per day on average
Penalties (3 years)
3Fines totaling $54,532

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
39D0695252Edenbrook of Greenwood Hill420 Pulaski Drive, Pottsville, PA 17901Certificate of waiverSep 12, 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
Mordechai Polstein Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Pottsville Realty LLC Organization, Skokie, IL LLC Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Maxim Stesel Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Carol Ann Miller-Schaeffer Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Bruce Kimball Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Channie B Lifsics Individual Adp of the SNF Feb 1, 2025
Gleb Zarkh Individual Adp of the SNF Feb 1, 2025
PA 6 Investors, LLC Organization, Skokie, IL LLC, Holding company Adp of the SNF Mar 2, 2026

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 6

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 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1215761879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-825-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PULASKI DR",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013634",
            "telephone_number": "773-825-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSVILLE SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-825-3336"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

Verify at the official NPI Registry.