Organization Active NPI

Newport LLC.

  • Skilled Nursing Facility
  • Modesto, CA
National Provider Identifier
1255938015
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
NEWPORT LLC.
Practice address
2030 Evergreen Ave
Modesto, CA 95350-3785
Phone
(916) 899-1315
NPI assigned
Oct 5, 2020
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Ryan Williams
Title
Partner
Phone
(916) 945-1248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2030 Evergreen Ave
Modesto, CA 95350-3785

Mailing address

599 Menlo Dr Ste 200
Rocklin, CA 95765-3725
Phone (916) 899-1315

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210521000942 CA Part A Provider - Skilled Nursing Facility 3173922267 Practice locations: Modesto, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255938015. Details of each certification follow.

Skilled nursing facility certification: CCN 555118

Legal name
NEWPORT LLC
Doing business as
ALMOND VISTA HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 14, 1979
Last certification
May 6, 2025
Beds
175
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jul 21, 2019 in CA
Enrollment address
2030 Evergreen Ave
Modesto, CA 95350-3785
Nursing home name
ALMOND VISTA HEALTHCARE
Affiliated entity
KALESTA HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Almond Vista HealthcareCCN 555118 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 14, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
175167.2 residents per day on average
Chain
Kalesta Healthcare Group19 facilities in the chain
Penalties (3 years)
5Fines totaling $25,881

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
05D0726157Almond Vista Healthcare2030 Evergreen Avenue, Modesto, CA 95350Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

599 Menlo Dr
Rocklin, CA 95765

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Ethan D Flake Individual Corporate DirectorRegional Director of Operations Oct 7, 2024
Operational/Managerial Control Oct 7, 2024
Sevinc Kayakoku Individual Operational/Managerial Control Mar 1, 2021
Scott Clawson Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2021 47.55%
Corporate OfficerManager Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Ishankumar R Modi Individual Corporate DirectorDirector of Therapy Services Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Terry Raines Individual Operational/Managerial Control Jul 15, 2024
Organization, North Hollywood, CA Adp of the SNF Feb 1, 2016
Mojdeh Javan Individual Operational/Managerial Control Feb 14, 2024
Domonique Fields Individual Corporate DirectorDirector of Revenue Management Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Vishaal Singh Individual Operational/Managerial Control Apr 26, 2023
Deborah Simms Individual Operational/Managerial Control Apr 6, 2023
Cortney Hinkle Individual Corporate DirectorHR/Ap/Payroll Director Jan 9, 2024
Operational/Managerial Control Jan 9, 2024
Ryan Williams Individual 5% Or Greater Indirect Ownership InterestManager Mar 1, 2021 47.55%
Corporate OfficerManager Mar 1, 2021
Operational/Managerial ControlManager Mar 1, 2021
Steven Mosher Individual Corporate DirectorDirector of It Services Jul 8, 2024
Operational/Managerial Control Jul 8, 2024
Rachandeep Singh Individual Operational/Managerial Control Mar 1, 2021
Adp of the SNF Mar 1, 2021
Diana Caballero Individual Operational/Managerial Control Jan 1, 2024
Michael Soares Individual Corporate DirectorDirector of Plant Operations Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Steven Jones Individual Corporate OfficerChief Operating Officer Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Kalesta Healthcare Group, LLC Organization, Rocklin, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2021 100%
Adp of the SNF Dec 18, 2025
Kai Shin Chen Individual Corporate OfficerController Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Harris Gregson Lachance Individual Operational/Managerial Control Feb 3, 2025
Adp of the SNF Feb 3, 2025
Capital Funding LLC Organization, Baltimore, MD 5% Or Greater Security Interest Mar 8, 2021 100%
Jeffrey Murray Individual Corporate DirectorClinical Services Director Jan 8, 2024
Operational/Managerial Control Jan 8, 2024

Owners & managing parties with NPI records 2

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1255938015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 MENLO DR STE 200",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653725",
            "telephone_number": "916-899-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 EVERGREEN AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503785",
            "telephone_number": "916-899-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "916-945-1248"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.