Active NPI
BSD Care at Aj, LLC
Doing business as The Pines at Philadelphia Rehabilitation and Healthcare Center
- Skilled Nursing Facility
- Philadelphia, PA
National Provider Identifier
1366904922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- BSD CARE AT AJ, LLC
- Doing business as
- The Pines at Philadelphia Rehabilitation and Healthcare Center
- Practice address
- 8410 Roosevelt Blvd
Philadelphia, PA 19152-2012 - Phone
- (215) 708-1200
- NPI assigned
- Apr 3, 2019
- Last updated
- Apr 3, 2019
- 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
- Abraham Kraus
- Title
- Managing Member
- Phone
- (732) 333-8175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
8410 Roosevelt Blvd
Philadelphia, PA 19152-2012
Mailing address
8410 Roosevelt Blvd
Philadelphia, PA 19152-2012
Other names 1
- The Pines at Philadelphia Rehabilitation and Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190621001155 | PA | Part A Provider - Skilled Nursing Facility | 7315271517 | Practice locations: Philadelphia, PA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1366904922. Details of each certification follow.
Skilled nursing facility certification: CCN 396070
- Legal name
- BSD CARE AT AJ LLC
- Doing business as
- THE PINES AT PHILADELPHIA REHABILITATION AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- May 18, 2000
- Last certification
- Sep 12, 2024
- Beds
- 49
- Ownership / control type
- Corporation
- Multi-facility organization
- Paramount Care Centers
- Organization structure
- Corporation
- Incorporated
- Mar 26, 2019 in PA
- Enrollment address
- 8410 Roosevelt Blvd
Philadelphia, PA 19152-2012 - Nursing home name
- THE PINES AT PHILADELPHIA REHAB AND HEALTHCARE CTR
- Affiliated entity
- PARAMOUNT CARE CENTERS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Pines at Philadelphia Rehab and Healthcare Ctr
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- May 18, 2000
- Medicare certification status
- Active
- Certified beds
- 49
- Chain
- Paramount Care Centers
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Morton Paneth | 5% Or Greater Direct Ownership Interest | May 31, 2019 | 8.33% |
| Shawne Mimna | W-2 Managing Employee | May 31, 2019 | 100% |
| Abraham Kraus | 5% Or Greater Direct Ownership Interest | May 31, 2019 | 75% |
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": "1554249600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1554249600000",
"number": "1366904922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8410 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8410 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191522012",
"telephone_number": "215-708-1200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BSD CARE AT AJ, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-04-03",
"last_updated": "2019-04-03",
"status": "A",
"authorized_official_last_name": "KRAUS",
"authorized_official_first_name": "ABRAHAM",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "732-333-8175"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Pines at Philadelphia Rehabilitation and Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Philadelphia, PA
- Sharmon Arvetta Bryant, MSW
- Sarah Bryski-Hamrick, LPC
- Alex Mays Bryson, LSW
- Katarzyna Anna Brzezinska, MD
- Barbara D Brzowski., CRNP
- BSD Care at Re, LLC (River's Edge Rehabilitation & Healthcare Center)
- Bsi Acquisition, LP (Broad Street Imaging)
- BT Enterprises (Farmacia)
- BT Enterprises (Trans Drug Store)
- BT Enterprises (Trans Drug Store)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.