Active NPI
Iowa Jewish Senior Life Center
- Skilled Nursing Facility
- Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- S384
- Legal business name
- IOWA JEWISH SENIOR LIFE CENTER
- Practice address
- 900 Polk Blvd
Des Moines, IA 50312-2225 - Phone
- (515) 255-5433
- Fax
- (515) 277-8898
- NPI assigned
- Oct 5, 2006
- 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
- Mr. Stephen P Blend
- Title
- Executive Director Administrator
- Phone
- (515) 255-5433
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | S384 | IA | |
| Skilled Nursing Facility | 314000000X | S384 | IA | Primary |
Addresses
Primary practice location
900 Polk Blvd
Des Moines, IA 50312-2225
Mailing address
900 Polk Boulevard
Des Moines, IA 50312-2225
Phone (515) 255-5433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0802025 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120321000412 | IA | Part A Provider - Skilled Nursing Facility | 5496915951 | Practice locations: Des Moines, IA |
Skilled nursing facility certification: CCN 165006
- Legal name
- IOWA JEWISH SENIOR LIFE CENTER
- Doing business as
- IOWA JEWISH SENIOR LIFE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Mar 13, 2025
- Beds
- 72 (46 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 900 Polk Blvd
Des Moines, IA 50312-2225 - Nursing home name
- IOWA JEWISH SENIOR LIFE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Iowa Jewish Senior Life Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 46
National Provider Directory
National Provider Directory- Tax ID family
- Iowa Jewish Senior Life Center
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Des Moines, IA
- NPI 1124188974
-
- Nursing Facility/Intermediate Care Facility
- Des Moines, IA
- NPI 1487807863
-
- Nursing Facility/Intermediate Care Facility
- Des Moines, IA
- NPI 1649423021
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Lazaro U Rabang | Operational/Managerial Control | Jan 1, 2022 | |
| Adp of the SNF | Jan 1, 2022 | ||
| Gloria Bernstein | Corporate Officer | Jul 1, 2017 | |
| Managing Control - Governing Body | Jul 1, 2017 | ||
| Beata Dorota Mock | Corporate Director | Nov 18, 2014 | |
| Angela Meyer | Corporate Director | May 1, 2022 | 100% |
| Operational/Managerial Control | May 1, 2022 | ||
| Adp of the SNF | Feb 26, 2025 | ||
| Polly Oxley | Corporate Officer | Jul 1, 2020 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Urbandale, IA
- NPI 1649387697
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1160006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1235225699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 POLK BOULEVARD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503122225",
"telephone_number": "515-255-5433",
"fax_number": "515-277-8898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 POLK BLVD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503122225",
"telephone_number": "515-255-5433",
"fax_number": "515-277-8898"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IOWA JEWISH SENIOR LIFE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-05",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "BLEND",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR ADMINISTRATOR",
"authorized_official_telephone_number": "515-255-5433",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IA",
"license": "S384",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IA",
"license": "S384",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0802025",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.