Active NPI
Hilborn Care Inc
- Skilled Nursing Facility
- Santa Rosa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- HILBORN CARE INC
- Doing business as
- Creekside Rehabilitation and Behavioral Health
- Practice address
- 850 Sonoma Ave
Santa Rosa, CA 95404-4715 - Phone
- (707) 544-7750
- NPI assigned
- Apr 11, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Josekutty Jose
- Title
- Ceo
- Phone
- (925) 999-0004
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
850 Sonoma Ave
Santa Rosa, CA 95404-4715
Mailing address
3700 Hilborn Rd Ste 800
Fairfield, CA 94534-7997
Phone (707) 439-3871
Other names 1
- Creekside Rehabilitation and Behavioral Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231220003970 | CA | Part A Provider - Skilled Nursing Facility | 3072963768 | Practice locations: Santa Rosa, CA |
Skilled nursing facility certification: CCN 056090
- Legal name
- HILBORN CARE, INC.
- Doing business as
- CREEKSIDE REHABILITATION & BEHAVIORAL HEALTH
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 1, 1974
- Last certification
- Nov 17, 2023
- Beds
- 181
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 5, 2022 in CA
- Enrollment address
- 850 Sonoma Ave
Santa Rosa, CA 95404-4715 - Nursing home name
- BLUE OAK POST-ACUTE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Blue Oak Post-Acute
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 1, 1974
- Medicare certification status
- Active
- Certified beds
- 181
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Raul Suratos | Operational/Managerial Control | Sep 16, 2024 | |
| Adp of the SNF | Sep 16, 2024 | ||
| April M Trask | Operational/Managerial Control | Mar 1, 2023 | |
| Adp of the SNF | Mar 1, 2023 | ||
| Eran Matalon | Operational/Managerial Control | Jan 1, 2002 | |
| Adp of the SNF | Jan 1, 2002 | ||
| Megan Rose | Operational/Managerial Control | Mar 1, 2023 | |
| Adp of the SNF | Mar 1, 2023 | ||
| Josekutty Jose | 5% Or Greater Direct Ownership Interest | Dec 5, 2022 | 100% |
| Corporate Officer | Dec 5, 2022 | ||
| Corporate Director | Dec 5, 2022 | ||
| Adp of the SNF | Mar 1, 2023 | ||
| Direct Ownership Interest | Mar 1, 2023 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Santa Rosa, CA
- NPI 1073656815
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Fairfield, CA
- NPI 1932358462
-
- Internal Medicine Physician
- Santa Rosa, CA
- NPI 1073656815
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": "1681171200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729036800000",
"number": "1326734625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 HILBORN RD STE 800",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945347997",
"telephone_number": "707-439-3871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 SONOMA AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954044715",
"telephone_number": "707-544-7750"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HILBORN CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-11",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A",
"authorized_official_last_name": "JOSE",
"authorized_official_first_name": "JOSEKUTTY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "925-999-0004"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Creekside Rehabilitation and Behavioral Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Creekside Rehabilitation and Behavioral Health",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.