Lake City FL Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE CITY FL OPCO LLC

Practice address

1270 SW Main Blvd
Lake City, FL 32025-6684

Phone

(386) 752-7900

NPI assigned

Mar 28, 2023

Last updated

Mar 28, 2023By 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

Batya Gorelick

Title

Manager

Phone

(201) 928-7808

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225732969. Details of each certification follow.

• CCN 105346 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105346

Legal name

LAKE CITY FL OPCO LLC

Doing business as

LAKE MONTGOMERY HEALTH AND REHABILATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 15, 1978

Last certification

Apr 11, 2024

Beds

95

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Lilac Health Group

Organization structure

LLCProprietary

Incorporated

in FL

Enrollment address

1270 SW Main Blvd
Lake City, FL 32025-6684

Nursing home name

LAKE MONTGOMERY HEALTH AND REHABILITATION CENTER

Affiliated entity

ROBERT SCHOENFELD

Listed as

Lake Montgomery Health and Rehabilitation CenterCCN 105346 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Aug 15, 1978

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9582.9 residents per day on average

Chain

Robert Schoenfeld8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

All disclosed owners & managing parties 5

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

Facilities with the same owner 4

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

• Lake Mariam FL Opco LLC

  • Skilled Nursing Facility
  • Winter Haven, FL
  • NPI 1114621851

  FL HC Opco LLC

  CMS ownership
• Orange Park FL Two Opco LLC

  • Skilled Nursing Facility
  • Orange Park, FL
  • NPI 1629772363

  FL HC Opco LLC

  CMS ownership
• Orlando FL Opco LLC

  • Skilled Nursing Facility
  • Orlando, FL
  • NPI 1215631965

  FL HC Opco LLC

  CMS ownership
• Port St. Lucie FL Opco LLC

  • Skilled Nursing Facility
  • Port St Lucie, FL
  • NPI 1649974387

  FL HC Opco LLC

  CMS ownership

Affiliated clinicians 3

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

• Ernest Paul De Leon, MD

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1558454603

  Nursing home

  Care Compare affiliation
• Rolando Dominguez Mustafa, M.D.

  • Adult Medicine Physician
  • Lake City, FL
  • NPI 1508145251

  Nursing home

  Care Compare affiliation
• Aaron James West, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Jacksonville, FL
  • NPI 1568456077

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1225732969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256684",
            "telephone_number": "386-752-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY FL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "GORELICK",
        "authorized_official_first_name": "BATYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-928-7808"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake City Cancer Care LLC
• Lake City Cancer Care LLC (Cancer Care of North Florida & Urology Medical of North Florida)
• Lake City Chiropractic and Massage
• Lake City Dental
• Lake City Eye Physicians, LLC
• Lake City Home Medical Equipment, Inc.
• Lake City Imaging LLC (Invision Imaging Center at Lake City)
• Lake City Medical Center Emergency Physicians, LLC
• Lake City MGT LLC (Avalon Healthcare Center)
• Lake City Nursing LLC (The Palms Nursing and Rehab at Lake City)

• Skilled Nursing Facility in Lake City, FL
• Providers in Lake City, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.