Active NPI
Bentwood Healthcare LLC
- Skilled Nursing Facility
- Florissant, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 040654
- Legal business name
- BENTWOOD HEALTHCARE LLC
- Practice address
- 1501 Charbonier Rd
Florissant, MO 63031-5308 - Phone
- (314) 921-2700
- NPI assigned
- Jul 3, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Judah Bienstock
- Title
- Managing Member
- Phone
- (314) 812-2550
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 040654 | MO | Primary |
Addresses
Primary practice location
1501 Charbonier Rd
Florissant, MO 63031-5308
Mailing address
1501 Charbonier Rd
Florissant, MO 63031-5308
Phone (314) 921-2700
Other names 1
- Bent-Wood Nursing Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120814000202 | MO | Part A Provider - Skilled Nursing Facility | 0244486884 | Practice locations: Florissant, MO |
Skilled nursing facility certification: CCN 265757
- Legal name
- BENTWOOD HEALTHCARE LLC
- Doing business as
- BENTWOOD NURSING & REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 16, 2003
- Last certification
- May 15, 2024
- Beds
- 116
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 1501 Charbonier Rd
Florissant, MO 63031-5308 - Nursing home name
- BENTWOOD NURSING & REHAB
- Affiliated entity
- MGM HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bentwood Nursing & Rehab
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 16, 2003
- Medicare certification status
- Active
- Certified beds
- 116
- Chain
- MGM Healthcare
- Penalties (3 years)
- 3
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0437355 | Bent-Wood Nursing Center | Certificate of waiver | Nov 7, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Tonya Lewis | W-2 Managing Employee | Feb 21, 2023 | 100% |
| Baruch Jeremias | 5% Or Greater Direct Ownership Interest | May 31, 2019 | 38.75% |
| Michael Riggins | W-2 Managing Employee | Jun 28, 2022 | 100% |
| Yb Acquisition LLC | 5% Or Greater Direct Ownership Interest | Dec 31, 2022 | 61.25% |
| Judah Bienstock | 5% Or Greater Indirect Ownership Interest | Dec 31, 2022 | 61.25% |
| Corporate Director | Aug 1, 2012 | 100% |
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Springfield, MO
- NPI 1700186939
Yb Acquisition LLC
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1740424704
-
- Rheumatology Physician
- Ballwin, MO
- NPI 1174597454
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": "1341273600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1449014400000",
"number": "1265796387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 CHARBONIER RD",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630315308",
"telephone_number": "314-921-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 CHARBONIER RD",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630315308",
"telephone_number": "314-921-2700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BENTWOOD HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-03",
"last_updated": "2015-12-02",
"status": "A",
"authorized_official_last_name": "BIENSTOCK",
"authorized_official_first_name": "JUDAH",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "314-812-2550"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MO",
"license": "040654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Bent-Wood Nursing Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.