19 Obery Street Operator LLC
Organization Active NPI Skilled Nursing Facility · Plymouth, MA
NPI 1295264679 · NPPES record last updated Jun 8, 2017
Key facts
- NPI
- 1295264679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 19 OBERY STREET OPERATOR LLC
- Practice address
- 19 Obery St
Plymouth, MA 02360-2129 - Phone
- (508) 747-4790
- Fax
- (508) 746-3880
- NPI assigned
- Jun 8, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- NEXT STEP HEALTHCARE LLC
Authorized official
- Name
- William Howard Stephan
- Title
- Chief Financial Officer
- Phone
- (617) 943-7747
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 1
-
Rohit Rattan, MD
Facilities with the same owner 13
Practitioners 1
-
Rohit Rattan, MD
Affiliated clinicians 1
-
Rohit Rattan, MD
Medicare Care Compare: Nursing home
- Listed as
- Plymouth Harborside Healthcare
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 1, 1985
- Medicare certification status
- Active
- Certified beds
- 101 · 77.4 residents per day on average
- Chain
- Next Step Healthcare
- Special focus status
- SFF Candidate
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 6 · fines totaling $321,400
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D2139934 | Plymouth Harborside Healthcare | Certificate of waiver | Nov 12, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Skilled nursing facility certification: CCN 225284
- Legal name
- 19 OBERY STREET OPERATOR LLC
- Doing business as
- PLYMOUTH HARBORSIDE HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 1, 1985
- Last certification
- Oct 23, 2024
- Beds
- 101
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Next Step Health Care
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 6, 2017 in MA
- Enrollment address
- 19 Obery St
Plymouth, MA 02360-2129 - Nursing home name
- PLYMOUTH HARBORSIDE HEALTHCARE
- Affiliated entity
- NEXT STEP HEALTHCARE
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Rohit Rattan |
Operational/Managerial Control | Nov 8, 2023 | |
| Adp of the SNF | Nov 8, 2023 | ||
| William Stephan |
5% Or Greater Indirect Ownership Interest |
Sep 1, 2017 | 50% |
| Corporate Officer |
Sep 1, 2017 | 50% | |
| Indirect Ownership Interest | Sep 1, 2017 | 50% | |
| Nina Nguyen |
Operational/Managerial Control | Apr 14, 2025 | |
| Adp of the SNF | Apr 14, 2025 | ||
| Damian Dell'Anno |
5% Or Greater Indirect Ownership Interest |
Sep 1, 2017 | 50% |
| Corporate Officer |
Sep 1, 2017 | 50% | |
| Indirect Ownership Interest | Sep 1, 2017 | 50% | |
| Next Step Healthcare LLC |
5% Or Greater Direct Ownership Interest | Sep 1, 2017 | 100% |
| Operational/Managerial Control | Sep 1, 2017 | 100% | |
| Adp of the SNF | Jun 24, 2025 | ||
| Direct Ownership Interest | Sep 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170817002323 | MA | Part a Provider - Skilled Nursing Facility | 5496027963 | Practice locations: Plymouth, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
19 Obery St
Plymouth, MA 02360-2129
Mailing address
75 2ND Ave Ste 605
Needham, MA 02494-2863
Phone (617) 943-7747
Other providers in Plymouth, MA
- 1620 Primary Care, PLLC
- 42 North Dental Care, LLC
- 5J Company
- A Place to Talk Therapy, LLC
- ABA Logic LLC
- Ramla Abbas
All providers in Plymouth, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.