NPIMap

Organization Active NPI

820 NW 95TH Street Operations LLC

  • Skilled Nursing Facility
  • Seattle, WA
National Provider Identifier
1285286559
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
820 NW 95TH STREET OPERATIONS LLC
Practice address
820 NW 95TH St
Seattle, WA 98117-2207
Phone
(206) 782-0100
Fax
(206) 782-0101
NPI assigned
Jul 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Michael T Berg, ASST SECRETARY
Title
Authorized Official
Phone
(505) 468-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

820 NW 95TH St
Seattle, WA 98117-2207

Mailing address

820 NW 95TH St
Seattle, WA 98117-2207
Phone (206) 782-0100

Other identifiers 2

IdentifierTypeStateIssuer
4114419MedicaidWA
1441OtherWALICENSE

Other names 1

  • BALLARD CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201111001605 TX Part A Provider - Skilled Nursing Facility 1658781166 Practice locations: Seattle, WA

Skilled nursing facility certification: CCN 505042

Legal name
820 NW 95TH STREET OPERATIONS LLC
Doing business as
BALLARD CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jan 8, 2025
Beds
142
Ownership / control type
Limited Liability Corporation
Organization structure
LLC
Enrollment address
820 NW 95TH St
Seattle, WA 98117-2207
Nursing home name
BALLARD CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ballard CenterCCN 505042
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14297.8 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
9560 Pico LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Adp of the SNF Oct 1, 2020
Bold Quail Holdings LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2020 100%
Adp of the SNF Oct 1, 2020
Pico Ar LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Adp of the SNF Oct 1, 2020
BQ Realty Holdings LLC Organization, Los Angeles, CA LLC, Holding company Adp of the SNF Oct 1, 2020
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
Newgen LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 100%
Adp of the SNF Oct 1, 2020
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC Adp of the SNF Oct 1, 2020
Tianziang Zhou Individual Operational/Managerial ControlChain Home Office Administrator Aug 12, 2024 100%
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Corporate OfficerExecutive Vice President Jan 1, 2020
Operational/Managerial Control Oct 1, 2020
Adp of the SNF Oct 1, 2020
Nishita Bhumkar Individual Operational/Managerial Control Aug 1, 2024
Adp of the SNF Aug 1, 2024
Pamela Shaw Individual Operational/Managerial ControlVP of RCM Aug 12, 2024 100%
Jose Brito Individual Operational/Managerial Control Oct 1, 2020
Adp of the SNF Jan 1, 2025
820 NW 95TH Street Property LLC Organization, Los Angeles, CA LLC Adp of the SNF Oct 1, 2020
Michael T Berg Individual Corporate OfficerAssistant Secretary, Treasurer Jan 1, 2020 100%
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Corporate OfficerCheif Executive Officer Jan 1, 2020
Operational/Managerial Control Oct 1, 2020
Adp of the SNF Oct 1, 2020

Owners & managing parties with NPI records 1

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

Facilities with the same owner 45

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

View all 45

Practitioners & affiliated clinicians

Practitioners 2

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": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1285286559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 NW 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172207",
            "telephone_number": "206-782-0100",
            "fax_number": "206-782-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 NW 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981172207",
            "telephone_number": "206-782-0100",
            "fax_number": "206-782-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "820 NW 95TH STREET OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "505-468-4742",
        "authorized_official_credential": "ASST SECRETARY"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114419",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1441",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BALLARD CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.