300 Pearl Street Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

300 PEARL STREET OPCO LLC

Practice address

300 Pearl St
Burlington, VT 05401-8531

Phone

(802) 658-4200

NPI assigned

Oct 2, 2024

Last updated

Oct 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yehuda A Raindel

Title

Cfo

Phone

(516) 430-5735

Specialties & licenses 1

Addresses

Other names 1

• Burlington Health & Rehabilitation Center Former legal business name

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316765878. Details of each certification follow.

• CCN 475014B Skilled nursing facility · Details

Skilled nursing facility certification: CCN 475014B

Legal name

300 PEARL STREET OPCO LLC

Doing business as

PREMIER REHAB AND HEALTHCARE AT BURLINGTON

Organization structure

LLCProprietary

Enrollment address

300 Pearl St
Burlington, VT 05401-8531

Nursing home name

PREMIER REHAB AND HEALTHCARE AT BURLINGTON

Affiliated entity

STELLAR HEALTH GROUP

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 7

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

Owners & managing parties with NPI records 1

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

• Mark Pitcher, M.D.

  • Internal Medicine Physician
  • South Burlington, VT
  • NPI 1285682666

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Mark Pitcher, M.D.

  • Internal Medicine Physician
  • South Burlington, VT
  • NPI 1285682666
  NPD (past)

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1316765878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTRAL AVE STE 107",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115598507",
            "telephone_number": "516-430-5735",
            "fax_number": "781-729-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PEARL ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018531",
            "telephone_number": "802-658-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "300 PEARL STREET OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "RAINDEL",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-430-5735"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlington Health & Rehabilitation Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• 300 Pearl Street Operations LLC (Burlington Health and Rehabilitation Center)
• 98 Starr Farm Road Operating Company, LLC (Elderwood at Burlington)
• A Vermont Counseling Group LLC
• A&M Home Care Corp
• Kimberly Jo Aakre, M.D.

• Skilled Nursing Facility in Burlington, VT
• Providers in Burlington, VT by specialty
• Skilled Nursing Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.

Verify at the official NPI Registry.