NPIMap

Organization Active NPI

Hammons Avenue Operating LLC

  • Skilled Nursing Facility
  • Berryville, AR
National Provider Identifier
1306547740
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAMMONS AVENUE OPERATING LLC
Practice address
500 Hammons Ave
Berryville, AR 72616-4300
Phone
(870) 423-6966
NPI assigned
Mar 13, 2023
Last updated
Jan 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Authorized official

Name
Yisroel Ganz
Title
Director
Phone
(732) 366-5705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

500 Hammons Ave
Berryville, AR 72616-4300

Mailing address

1999 Cedarbridge Ave Ste 3B
Lakewood, NJ 08701-6915
Phone (732) 366-5705

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240905001354 AR Part A Provider - Skilled Nursing Facility 8426598442 Practice locations: Berryville, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306547740. Details of each certification follow.

Skilled nursing facility certification: CCN 045295

Legal name
HAMMONS AVENUE OPERATING LLC
Doing business as
THE BLOSSOMS AT BERRYVILLE REHAB & NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1995
Last certification
Aug 8, 2024
Beds
114
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Oasis
Organization structure
LLCProprietary
Incorporated
Feb 28, 2023 in AR
Enrollment address
500 Hammons Ave
Berryville, AR 72616-4300
Nursing home name
THE BLOSSOMS AT BERRYVILLE REHAB & NURSING CENTER
Affiliated entity
THE BLOSSOMS REHAB & NURSING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Blossoms at Berryville Rehab & Nursing CenterCCN 045295 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11466.9 residents per day on average
Chain
The Blossoms Rehab & Nursing Center23 facilities in the chain
Penalties (3 years)
2Fines totaling $22,880

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Organization, Lakewood, NJ Corporation, Financial institution, Consulting firm Adp of the SNF Apr 5, 2023
Individual Adp of the SNF Apr 5, 2023
Individual Adp of the SNF Apr 5, 2023
Matisyohu Herzka Individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
Sisah Staffing Solutions LLC Organization, Newark, NJ LLC, Medical staffing company Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Aks Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.34%
Abraham Schreiber Individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.34%
Missouri LTC Pharmacy LLC Organization, Fenton, MO LLC, Medical provider/supplier Adp of the SNF Apr 1, 2023
Jason L Ketcher Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 5, 2023
Diamond Opco Holding LLC Organization, Hot Springs, AR LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2023 100%
MH Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
ZCS Ar Opco LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 5, 2023 33.33%
Oasis Health Care Group, LLC Organization, Lakewood, NJ LLC, Management services company Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Tammy L Romero Individual Operational/Managerial Control Apr 5, 2023
Adp of the SNF Apr 5, 2023
Shlomo Z Scheinbaum Individual 5% Or Greater Indirect Ownership InterestCeo Apr 1, 2023 33.33%
Operational/Managerial Control Apr 1, 2023
Managing Control - Governing BodyCeo Apr 1, 2023
Adp of the SNF Apr 1, 2023
Organization, Lakewood, NJ LLC, Consulting firm Adp of the SNF Apr 5, 2023
Organization, Portland, OR LLC, Consulting firm Adp of the SNF Mar 15, 2021

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 22

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

View all 22

Practitioners & affiliated clinicians

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": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1306547740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 CEDARBRIDGE AVE STE 3B",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016915",
            "telephone_number": "732-366-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HAMMONS AVE",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164300",
            "telephone_number": "870-423-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMMONS AVENUE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "YISROEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-366-5705"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

Verify at the official NPI Registry.