Organization Active NPI

Omci Operations LLC

  • Skilled Nursing Facility
  • Tulsa, OK
National Provider Identifier
1376330597
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
OMCI OPERATIONS LLC
Practice address
3333 E 28TH St
Tulsa, OK 74114-5915
Phone
(918) 203-0606
NPI assigned
Apr 22, 2025
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
David Ganz
Title
LLC Manager
Phone
(832) 422-8848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

3333 E 28TH St
Tulsa, OK 74114-5915

Mailing address

3333 E 28TH St
Tulsa, OK 74114-5915
Phone (918) 203-0606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260223001043 OK Part A Provider - Skilled Nursing Facility 3072094606 Practice locations: Tulsa, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376330597. Details of each certification follow.

Skilled nursing facility certification: CCN 375468

Legal name
OMCI OPERATIONS LLC
Doing business as
OKLAHOMA MEMORY CARE INSTITUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 23, 2004
Last certification
Oct 31, 2024
Beds
56
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
3333 E 28TH St
Tulsa, OK 74114-5915
Nursing home name
OKLAHOMA MEMORY CARE INSTITUTE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oklahoma Memory Care InstituteCCN 375468 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 23, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5639.6 residents per day on average
Penalties (3 years)
1Fines totaling $8,653

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0473978Oklahoma Memory Care Institute3333 E 28TH Street, Tulsa, OK 74114Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

15112 Traditions Blvd
Ste A
Edmond, OK 73013
Phone (405) 289-0483

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Rivers Edge Partners II LLC Organization, Brick, NJ LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2025 50%
Avrohom Kravetz Individual Indirect Ownership Interest Jun 1, 2025 10%
David M Ganz Individual 5% Or Greater Indirect Ownership InterestBusiness Manager/Officer Jun 1, 2025 40%
Operational/Managerial Control Jun 1, 2025
Managing Control - Governing BodyBusiness Manager/Officer Jun 1, 2025
Adp of the SNF Jun 1, 2025
Rivers Edge Operations III LLC Organization, Brick, NJ LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Jun 1, 2025 100%
Michael Rife Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
Yaacov Hanover Individual Adp of the SNF Jun 1, 2025
Indirect Ownership Interest Jun 1, 2025 15%
Joseph M Moore Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
Skyblue Healthcare Management LLC Organization, Houston, TX LLC, Management services company, For-profit Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jan 26, 2026
Omci Realty LLC Organization, Brick, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Mortgage Interest Jun 1, 2025 100%
Adp of the SNF Jun 1, 2025
Organization, Cleveland, OH LLC, For-profit Adp of the SNF Jan 26, 2026
S. Aryeh Retter Individual 5% Or Greater Indirect Ownership InterestBusiness Manager Jun 1, 2025 35%
Operational/Managerial Control Jun 1, 2025
Managing Control - Governing BodyBusiness Manager Jun 1, 2025
Adp of the SNF Jun 1, 2025
Individual Adp of the SNF Jun 1, 2025
Rivers Edge Property Holdings III LLC Organization, Brick, NJ LLC, Holding company, For-profit Adp of the SNF Jun 1, 2025
Organization, Brick, NJ LLC, For-profit Adp of the SNF Jan 26, 2026

Owners & managing parties with NPI records 1

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1376330597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E 28TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741145915",
            "telephone_number": "918-203-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E 28TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741145915",
            "telephone_number": "918-203-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMCI OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "GANZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "LLC MANAGER",
        "authorized_official_telephone_number": "832-422-8848"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.