Boundary Street SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BOUNDARY STREET SNF LLC

Doing business as

Robison Jewish Health Center

Practice address

6125 SW Boundary St
Portland, OR 97221-1019

Phone

(323) 350-7772

NPI assigned

Aug 13, 2024

Last updated

Aug 13, 2024By 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

Yehuda Schmukler

Title

Owner

Phone

(323) 350-7772

Specialties & licenses 1

Addresses

Other names 1

• Robison Jewish Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255162863. Details of each certification follow.

• CCN 385145 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 385145

Legal name

BOUNDARY STREET SNF, LLC

Doing business as

ROBISON JEWISH HEALTH CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 1, 1979

Last certification

Aug 2, 2024

Beds

92

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Jul 3, 2024 in OR

Enrollment address

6125 SW Boundary St
Portland, OR 97221-1019

Nursing home name

ROBISON JEWISH HEALTH CENTER

Listed as

Robison Jewish Health CenterCCN 385145 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Nov 1, 1979

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9293.0 residents per day on average

Penalties (3 years)

2Fines totaling $48,520

Processed by Care Compare on Aug 1, 2026.

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Nita Vellody, DO

  • Internal Medicine Physician
  • Springfield, OR
  • NPI 1912101338

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nita Vellody, DO

  • Internal Medicine Physician
  • Springfield, OR
  • NPI 1912101338
  NPD (past)

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1255162863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6125 SW BOUNDARY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972211019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6125 SW BOUNDARY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972211019",
            "telephone_number": "323-350-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNDARY STREET SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "SCHMUKLER",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-350-7772"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robison Jewish Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Boulder Care Provider Group PA (Boulder Care)
• Conor Boulger
• Tyler Dallin Boulter, MD
• Ann Bouma
• Lucas Benjamin Boumann
• Boundless Assistive Technology, LLC (Boundless AT)
• Emily Rose Bounds
• Sandy Leiko Bounds, RPH
• Dennis Neil Bourdette, MD
• Jacqueline Bourdette, D.M.D.

• Skilled Nursing Facility in Portland, OR
• Providers in Portland, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.