Wallis Road Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WALLIS ROAD OPCO LLC

Practice address

5065 Wallis Rd
West Palm Beach, FL 33415-1947

Phone

(561) 689-1799

Fax

(561) 640-4603

NPI assigned

Aug 3, 2023

Organization subpart

No

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

Authorized official

Name

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at West Palm Beach Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Skilled nursing facility certification: CCN 105558

Legal name

WALLIS ROAD OPCO LLC

Doing business as

AVIATA AT WEST PALM BEACH

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 9, 1986

Last certification

May 31, 2024

Beds

120

Ownership / control type

Corporation

Organization structure

LLCProprietary

Incorporated

Jul 26, 2023 in FL

Enrollment address

5065 Wallis Rd
West Palm Beach, FL 33415-1947

Nursing home name

AVIATA AT WEST PALM BEACH

Affiliated entity

AVIATA HEALTH GROUP

Listed as

Aviata at West Palm BeachCCN 105558

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 9, 1986

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120112.7 residents per day on average

Chain

Aviata Health Group50 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

3Fines totaling $33,790

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

• 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)
• HealthSun Health Plans Network
• 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 Maximo (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)…

All disclosed owners & managing parties 9

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.

• Yanitza Rodriguez, M.D

  • Internal Medicine Physician
  • Boynton Beach, FL
  • NPI 1356515019

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• Yanitza Rodriguez, M.D

  • Internal Medicine Physician
  • Boynton Beach, FL
  • NPI 1356515019

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1245912724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5065 WALLIS RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334151947",
            "telephone_number": "561-689-1799",
            "fax_number": "561-640-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5065 WALLIS RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334151947",
            "telephone_number": "561-689-1799",
            "fax_number": "561-640-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLIS ROAD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at West Palm Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Wallace
• Topazs Wallace
• Lorna Wallach, M.ED
• Maitri Wallen
• Monica Danielle Walling, LMHC
• Stuart Wally
• Sierra Walton, PHARMD
• Wandy Premier Group LLC
• John Lin Wang, M.D.
• Morcos L. Wanis, MD

• Skilled Nursing Facility in West Palm Beach, FL
• Providers in West Palm Beach, 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 Apr 9, 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.

Verify at the official NPI Registry.