Richmond Beach Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RICHMOND BEACH REHAB LLC

Practice address

19235 15TH Ave NW
Shoreline, WA 98177-2725

Phone

(206) 546-2666

Fax

(206) 542-1164

NPI assigned

Sep 18, 2005

Last updated

Jul 15, 2025By 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

Mary E. Kofstad

Title

Ceo

Phone

(971) 224-2033

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316932114. Details of each certification follow.

• CCN 505488 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 505488

Legal name

RICHMOND BEACH REHAB LLC

Doing business as

RICHMOND BEACH REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 18, 1994

Last certification

Nov 29, 2024

Beds

131

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Avamere Living

Organization structure

LLCProprietary

Enrollment address

19235 15TH Ave NW
Shoreline, WA 98177-2725

Nursing home name

RICHMOND BEACH REHAB

Affiliated entity

AVAMERE

Listed as

Richmond Beach RehabCCN 505488 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 18, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

13198.6 residents per day on average

Chain

Avamere27 facilities in the chain

Penalties (3 years)

1Fines totaling $44,753

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Richmond Beach Rehab LLC

  • Skilled Nursing Facility
  • Shoreline, WA
  • NPI 1710218656
  NPD tax ID

All disclosed owners & managing parties 46

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 2

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

• Arash Mirzaie Amirabadi, MD

  • Family Medicine Physician
  • Bellevue, WA
  • NPI 1750679767

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Misty Reid, AGACNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor, CO
  • NPI 1851992176

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 23

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

• Burien Operations, LLC

  dba Avamere Rehabilitation of Burien

  • Skilled Nursing Facility
  • Burien, WA
  • NPI 1912619321

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Georgian Rehab, LLC

  dba Avamere Transitional Care of Puget Sound

  • Skilled Nursing Facility
  • Tacoma, WA
  • NPI 1508904467

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Issaquah Operations, LLC

  dba Avamere Rehabilitation of Issaquah

  • Skilled Nursing Facility
  • Issaquah, WA
  • NPI 1053023499

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Seattle Operations, LLC

  • Skilled Nursing Facility
  • Seattle, WA
  • NPI 1982948535

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Sequim Rehabilitation LLC

  dba Avamere Olympic Rehabilitation of Sequim

  • Skilled Nursing Facility
  • Sequim, WA
  • NPI 1538146378

  Avamere Health Services LLC

  CMS ownership
• Shoreline Operations, LLC

  dba Avamere Rehabilitation of Shoreline

  • Skilled Nursing Facility
  • Shoreline, WA
  • NPI 1366154791

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• SW Seattle Operations, LLC

  dba Avamere Rehabilitation of Park West

  • Skilled Nursing Facility
  • Seattle, WA
  • NPI 1336851773

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Tacoma Rehab, LLC

  dba Avamere at Pacific Ridge

  • Skilled Nursing Facility
  • Tacoma, WA
  • NPI 1053459925

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Clackamas Rehabilitation, LLC

  dba Avamere Rehabilitation of Clackamas

  • Skilled Nursing Facility
  • Gladstone, OR
  • NPI 1518001205

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Coos Bay Rehabilitation, LLC

  dba Avamere Rehabilitation of Coos Bay

  • Skilled Nursing Facility
  • Coos Bay, OR
  • NPI 1831233519

  Avamere Health Services LLC, Avamere Skilled Advisors LLC

  CMS ownership
• Crestview Operations, LLC

  dba Avamere Crestview of Portland

  • Skilled Nursing Facility
  • Portland, OR
  • NPI 1922046606

  Avamere Health Services LLC, Avamere Skilled Advisors LLC, Midcap Finco LLC

  CMS ownership
• Eugene Rehabilitation, LLC

  dba Avamere Rehabilitation of Eugene

  • Skilled Nursing Facility
  • Eugene, OR
  • NPI 1265576946

  Avamere Health Services LLC

  CMS ownership

Practitioners 6

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.

• Jennifer Lynn Azen, M.D., M.P.H.

  • Internal Medicine Physician
  • Kent, WA
  • NPI 1073703294
  NPD (past)
• Jocelyn A Burgos-Dago-Oc, M.D.

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1821251372
  NPD (past)
• Isabela Cardim, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Seattle, WA
  • NPI 1003196478
  NPD (past)
• Neel Ramesh Chheda, DO

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1336678382
  NPD (past)
• Arash Mirzaie Amirabadi, MD

  • Family Medicine Physician
  • Bellevue, WA
  • NPI 1750679767
  NPD (past)
• George Paris, M.D.

  • Internal Medicine Physician
  • Wenatchee, WA
  • NPI 1851533913
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jennifer Lynn Azen, M.D., M.P.H.

  • Internal Medicine Physician
  • Kent, WA
  • NPI 1073703294

  Nursing home

  Care Compare affiliation
• Jocelyn A Burgos-Dago-Oc, M.D.

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1821251372

  Nursing home

  Care Compare affiliation
• Arash Mirzaie Amirabadi, MD

  • Family Medicine Physician
  • Bellevue, WA
  • NPI 1750679767

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1316932114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19235 15TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772725",
            "telephone_number": "206-546-2666",
            "fax_number": "206-542-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19235 15TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981772725",
            "telephone_number": "206-546-2666",
            "fax_number": "206-542-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND BEACH REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-18",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "KOFSTAD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "971-224-2033"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113460",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinServi",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frances Harllee Rice, LMT
• Kelsey Rice
• Richard T. Jones, DDS, PS
• Gabrielle Richardson, LCPO
• Kathryn Joy Richardson
• Richmond Beach Rehab LLC
• Richmond Clinic TR (Richmond Clinic)
• Richmond Internal Medicine, P.S.
• Richmond Pediatric Clinic Inc. P.S.
• Richmond Senior Care LLC

• Skilled Nursing Facility in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.