NPIMap

Organization Active NPI

800 Medcalf Lane North Operations LLC

Doing business as Montesano Health-Rehab Center

  • Skilled Nursing Facility
  • Montesano, WA
National Provider Identifier
1386028397
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
800 MEDCALF LANE NORTH OPERATIONS LLC
Doing business as
Montesano Health-Rehab Center
Practice address
800 N Medcalf LN
Montesano, WA 98563-1318
Phone
(360) 249-2273
Fax
(360) 249-2363
NPI assigned
Jul 20, 2015
Last updated
Mar 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Michael T Berg
Title
Assistant Secretary
Phone
(505) 468-4742

Specialties & licenses 1

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

Addresses

Primary practice location

800 N Medcalf LN
Montesano, WA 98563-1318

Mailing address

800 N Medcalf LN
Montesano, WA 98563-1318
Phone (360) 249-2273

Other names 1

  • Montesano Health-Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260212003637 WA Part A Provider - Skilled Nursing Facility 2264733534 Practice locations: Montesano, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386028397. Details of each certification follow.

Skilled nursing facility certification: CCN 505537

Legal name
800 MEDCALF LANE NORTH OPERATIONS LLC
Doing business as
MONTESANO HEALTH-REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 19, 2025
Last certification
Sep 19, 2025
Beds
94
Ownership / control type
Corporation
Multi-facility organization
NewGen Heal
Organization structure
LLC
Enrollment address
800 N Medcalf LN
Montesano, WA 98563-1318
Nursing home name
MONTESANO HEALTH-REHAB CENTER
Affiliated entity
GENESIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Montesano Health-Rehab CenterCCN 505537 · All quality measures
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 19, 2025
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9431.4 residents per day on average
Chain
Genesis Healthcare184 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

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
Neel Ramesh Chheda Individual Operational/Managerial Control Jan 30, 2025
Adp of the SNF Jan 30, 2025
Megan Rolfing Individual Operational/Managerial Control Aug 12, 2024
Adp of the SNF Aug 12, 2024
9560 Pico LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Adp of the SNF Feb 1, 2020
Bold Quail Holdings LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2020 100%
Adp of the SNF Feb 1, 2020
Pico Ar LLC Organization, Los Angeles, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Adp of the SNF Feb 1, 2020
BQ Realty Holdings LLC Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Feb 13, 2026
Newgen LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 100%
Adp of the SNF Feb 1, 2020
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Feb 1, 2020
Andrea Moeun Individual Operational/Managerial Control May 28, 2024
Adp of the SNF May 28, 2024
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Corporate DirectorVice President Nov 3, 2025
Operational/Managerial Control Feb 1, 2020
Adp of the SNF Feb 1, 2020
Genesis Healthcare LLC Organization, Kennett Square, PA Holding company, For-profit Adp of the SNF Feb 1, 2020
BQ Operations Holdings LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2020 100%
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest Apr 20, 2026 50%
Operational/Managerial Control Feb 1, 2020
Adp of the SNF Feb 1, 2020
800 Medcalf Lane North Property LLC Organization, Montesano, WA LLC, For-profit Adp of the SNF Feb 1, 2020

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 45

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

View all 45

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

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": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1386028397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MEDCALF LN",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985631318",
            "telephone_number": "360-249-2273",
            "fax_number": "360-249-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MEDCALF LN",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985631318",
            "telephone_number": "360-249-2273",
            "fax_number": "360-249-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "800 MEDCALF LANE NORTH OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montesano Health-Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montesano, WA

Sources for this page

Verify at the official NPI Registry.