Organization Active NPI

Foremost at Sharon LLC

  • Skilled Nursing Facility
  • Sharon, MA
National Provider Identifier
1255967428
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FOREMOST AT SHARON LLC
Practice address
259 Norwood St
Sharon, MA 02067-1099
Phone
(781) 784-6781
NPI assigned
Mar 19, 2020
Last updated
Sep 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Rachel Shakow
Title
Operator
Phone
(646) 660-2350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

259 Norwood St
Sharon, MA 02067-1099

Mailing address

100 Boulevard of the Americas
Lakewood, NJ 08701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201013003083 MA Part A Provider - Skilled Nursing Facility 0143640177 Practice locations: Sharon, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255967428. Details of each certification follow.

Skilled nursing facility certification: CCN 225134B

Legal name
FOREMOST AT SHARON LLC
Organization structure
LLCProprietary
Enrollment address
259 Norwood St
Sharon, MA 02067-1099
Nursing home name
FOREMOST AT SHARON LLC

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
22D0074395Foremost at Sharon259 Norwood Street, Sharon, MA 02067Certificate of waiverMar 6, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Amitai Dagan Individual 5% Or Greater Direct Ownership InterestOwner Sep 1, 2020 30%
Rachel Shakow Individual 5% Or Greater Direct Ownership InterestOwner Sep 1, 2020 70%
Corporate Director Sep 1, 2020
W-2 Managing Employee Sep 1, 2020

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1255967428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BOULEVARD OF THE AMERICAS",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 NORWOOD ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671099",
            "telephone_number": "781-784-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREMOST AT SHARON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "SHAKOW",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "646-660-2350"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, MA

Sources for this page

Verify at the official NPI Registry.