Organization Active NPI

Sidney Rehab LLC

  • Skilled Nursing Facility
  • Sidney, OH
National Provider Identifier
1255071676
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SIDNEY REHAB LLC
Practice address
510 Buckeye Ave
Sidney, OH 45365-1214
Phone
(937) 492-3171
NPI assigned
Apr 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Michael Tenenbaum
Title
Ceo
Phone
(817) 613-5764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

510 Buckeye Ave
Sidney, OH 45365-1214

Mailing address

1837 E 33Rd St
Brooklyn, NY 11234-4425
Phone (917) 613-5764

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220608001271 OH Part A Provider - Skilled Nursing Facility 7810375565 Practice locations: Sidney, OH

Skilled nursing facility certification: CCN 366033

Legal name
SIDNEY REHAB LLC
Doing business as
MOMENTOUS HEALTH AT SIDNEY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 18, 1995
Last certification
Oct 17, 2024
Beds
51
Ownership / control type
Limited Liability Corporation
Multi-facility organization
MOMENTOUS HEALTHCARE
Most recent change of ownership
May 1, 2022
Organization structure
LLCProprietary
Incorporated
Feb 15, 2022 in DE
Enrollment address
510 Buckeye Ave
Sidney, OH 45365-1214
Nursing home name
MOMENTOUS HEALTH AT SIDNEY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Momentous Health at SidneyCCN 366033 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 18, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5143.2 residents per day on average

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
36D0348601Sidney Rehab LLC Dba Momentous Health510 Buckeye Avenue, Sidney, OH 45365Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Momentous Health at Vandalia2 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.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Michael J Tenenbaum Individual 5% Or Greater Direct Ownership InterestCeo May 1, 2022 50%
Corporate OfficerCeo May 1, 2022
Adp of the SNF Feb 1, 2022
Mandy Walter Individual Operational/Managerial Control Oct 15, 2024
Adp of the SNF Oct 15, 2024
Miguel Topalov Individual Adp of the SNF Oct 1, 2024
Mark Stein Individual 5% Or Greater Direct Ownership Interest May 1, 2022 50%
Corporate OfficerCfo May 1, 2022
Adp of the SNF May 1, 2022

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1255071676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 E 33RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344425",
            "telephone_number": "917-613-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BUCKEYE AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651214",
            "telephone_number": "937-492-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "TENENBAUM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-613-5764"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

Verify at the official NPI Registry.