CC PDR Scottsdale LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-2616 Issued in AZ

Legal business name

CC PDR SCOTTSDALE LLC

Doing business as

Vi at Grayhawk, a Vi and Plaza Companies Community

Practice address

7501 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4525

Phone

(480) 361-3200

Fax

(480) 659-5110

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Tomek J Koszylko

Title

Counsel

Phone

(312) 803-8443

Specialties & licenses 1

Addresses

Other names 1

• Vi at Grayhawk, a Vi and Plaza Companies Community Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235334541. Details of each certification follow.

• CCN 035272 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 035272

Legal name

CC PDR SCOTTSDALE LLC

Doing business as

VI AT GRAYHAWK

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Sep 19, 2008

Last certification

Feb 27, 2024

Beds

36

Ownership / control type

Partnership

Organization structure

LLCProprietary

Enrollment address

7501 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4525

Nursing home name

VI AT GRAYHAWK, A VI AND PLAZA COMPANIES COMMUNITY

Affiliated entity

VI LIVING

Listed as

Vi at Grayhawk, a Vi and Plaza Companies CommunityCCN 035272 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare

Ownership

For profit - Partnership

Certified

Sep 19, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3634.1 residents per day on average

Chain

VI Living9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

CC PDR Scottsdale LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• CC PDR Scottsdale LLC

  dba Vi at Grayhawk

  • Assisted Living Facility
  • Scottsdale, AZ
  • NPI 1891255139
  NPD tax ID

All disclosed owners & managing parties 32

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.

• Artur Miernik, D.O.

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1881806693

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 9

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

• CC PDR Silverstone L L C

  dba Vi at Silverstone

  • Skilled Nursing Facility
  • Scottsdale, AZ
  • NPI 1093019770

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Aventura LLC

  dba Vi at Aventura

  • Skilled Nursing Facility
  • Aventura, FL
  • NPI 1255385274

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Denver LLC

  dba Vi at Highlands Ranch Skilled Nursing

  • Skilled Nursing Facility
  • Highlands Ranch, CO
  • NPI 1962635037

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Hilton Head LLC

  dba Broad Creek Care Center

  • Skilled Nursing Facility
  • Hilton Head Island, SC
  • NPI 1578553871

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Lake LLC

  dba Vi at The Glen

  • Skilled Nursing Facility
  • Glenview, IL
  • NPI 1649220906

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Naples LLC

  dba Bentley Care Center

  • Skilled Nursing Facility
  • Naples, FL
  • NPI 1013954353

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CC Palo Alto LLC

  dba Vi at Palo Alto

  • Skilled Nursing Facility
  • Palo Alto, CA
  • NPI 1295774172

  CC-Development Group, Inc., Classic Residence Management Limited Partnership

  CMS ownership
• CCW la Jolla, LLC

  • Skilled Nursing Facility
  • San Diego, CA
  • NPI 1972574507

  Classic Residence Management Limited Partnership

  CMS ownership
• Meridian Park Village Limited Partnership

  dba Vi at Lakeside Village

  • Skilled Nursing Facility
  • Lantana, FL
  • NPI 1568423234

  Classic Residence Management Limited Partnership

  CMS ownership

Affiliated clinicians 6

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

• Jill A Borovansky, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1780664714

  Nursing home

  Care Compare affiliation
• Jay S Friedman, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1821163825

  Nursing home

  Care Compare affiliation
• Salma Jesmin, MD

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1912115742

  Nursing home

  Care Compare affiliation
• Douglas M. Lakin, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1992783492

  Nursing home

  Care Compare affiliation
• Artur Miernik, D.O.

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1881806693

  Nursing home

  Care Compare affiliation
• Andrea Katherine Tuthill, APNP

  • Family Nurse Practitioner
  • Honolulu, HI
  • NPI 1144777434

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1235334541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S WACKER DR STE 8400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606066316",
            "telephone_number": "312-803-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 E THOMPSON PEAK PKWY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554525",
            "telephone_number": "480-361-3200",
            "fax_number": "480-659-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC PDR SCOTTSDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "KOSZYLKO",
        "authorized_official_first_name": "TOMEK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COUNSEL",
        "authorized_official_telephone_number": "312-803-8443"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-2616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vi at Grayhawk, a Vi and Plaza Companies Community",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vi at Grayhawk, a Vi and Plaza Companies Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cave Creek Unified Schools
• Michael Stephen Cavender, DDS
• John N Caviness, M.D.
• CB Growth Mindset LLC (CB Growth Mindset)
• CBBL Entreprises LLC (BrightStar of Greater Scottsdale)
• CC PDR Scottsdale LLC (Vi at Grayhawk)
• CC PDR Silverstone L L C (Vi at Silverstone)
• CC PDR Silverstone L L C (Vi at Silverstone)
• CCC Karakey LLC (Claibourne Counseling)
• CDC Group Inc

• Skilled Nursing Facility in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.