Organization Active NPI

Casey Rehab and Nursing LLC

  • Skilled Nursing Facility
  • Casey, IL
National Provider Identifier
1386471886
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CASEY REHAB AND NURSING LLC
Practice address
100 NE 15TH St
Casey, IL 62420-2152
Phone
(217) 932-5217
Fax
(217) 932-5408
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Benjamin Friedman
Title
Cfo
Phone
(845) 414-3300

Specialties & licenses 1

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

Addresses

Primary practice location

100 NE 15TH St
Casey, IL 62420-2152

Mailing address

7B Medical Park Dr
Pomona, NY 10970-3516
Phone (845) 414-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250404000033 IL Part A Provider - Skilled Nursing Facility 6305360082 Practice locations: Casey, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386471886. Details of each certification follow.

Skilled nursing facility certification: CCN 146117

Legal name
CASEY REHAB AND NURSING LLC
Doing business as
CASEY REHAB AND NURSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 10, 2007
Last certification
Jan 17, 2025
Beds
69
Ownership / control type
Partnership
Most recent change of ownership
Aug 1, 2020
Organization structure
LLCProprietary
Incorporated
Sep 13, 2024 in IL
Enrollment address
100 NE 15TH St
Casey, IL 62420-2152
Nursing home name
CASEY REHAB AND NURSING
Affiliated entity
STERN CONSULTANTS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Casey Rehab and NursingCCN 146117 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Aug 10, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6948.0 residents per day on average
Chain
Stern Consultants22 facilities in the chain
Penalties (3 years)
2Fines totaling $66,580

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
14D0683305Casey Rehab & Nursing LLC100 N E 15TH St, Casey, IL 62420Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Tlco Holdings LLC Organization, Pomona, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 23.5%
Operational/Managerial Control Dec 1, 2024
Individual Indirect Ownership Interest Dec 1, 2024 2%
Individual Adp of the SNF Nov 20, 2024
Direct Ownership Interest Dec 1, 2024 1%
Boruch Sheps Individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 10%
Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Organization, San Clemente, CA Real estate investment trust (REIT) Adp of the SNF Dec 1, 2024
Avraham Erblich Individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 16%
Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Chaim Millman Individual Operational/Managerial Control Dec 1, 2024
Managing Control - Governing Body Dec 1, 2024
Trustee of the SNF Dec 1, 2024
Adp of the SNF Dec 1, 2024
Indirect Ownership Interest Dec 1, 2024 1%
Etn Family Holdings LLC Organization, Pomona, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 23.5%
Operational/Managerial Control Dec 1, 2024
Adp of the SNF Mar 6, 2025
Amanda Jordan Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Organization, Skokie, IL LLC Adp of the SNF Apr 4, 2025
Benjamin Friedman Individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 15%
Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
James McGill Individual Operational/Managerial Control Dec 1, 2024
Bezalel Stern Individual Direct Ownership Interest Dec 1, 2024 4.5%
T Newhouse Family Trust Organization, Pomona, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2024 11.6%
Asad Zaman Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Individual Adp of the SNF Dec 1, 2024
Organization, Plainfield, IL LLC Adp of the SNF Dec 1, 2024
Organization, San Clemente, CA Adp of the SNF Dec 1, 2024
Eric Newhouse Individual Operational/Managerial Control Dec 1, 2024
Managing Control - Governing BodyManager of the Manager Dec 1, 2024
Trustee of the SNF Dec 1, 2024
Indirect Ownership Interest Dec 1, 2024 1%
Com Family Trust Organization, Pomona, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2024 11.6%
TLM Family Trust Organization, Pomona, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2024 11.6%
Individual Trustee of the SNF Dec 1, 2024
Individual Adp of the SNF Nov 20, 2024
Direct Ownership Interest Dec 1, 2024 2%
Temi Newhouse Individual Trustee of the SNF Dec 1, 2024
The Estate of Peter Schorr Organization, Cedarhurst, NY Corporation, LLC, Holding company, For-profit Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Direct Ownership Interest Dec 1, 2024 3%
E Newhouse Family Trust Organization, Pomona, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2024 11.6%
Individual Indirect Ownership Interest Dec 1, 2024 0.9%
Individual Adp of the SNF Nov 20, 2024
Direct Ownership Interest Dec 1, 2024 1.5%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1386471886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7B MEDICAL PARK DR",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703516",
            "telephone_number": "845-414-3300",
            "fax_number": "845-517-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE 15TH ST",
            "city": "CASEY",
            "state": "IL",
            "postal_code": "624202152",
            "telephone_number": "217-932-5217",
            "fax_number": "217-932-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY REHAB AND NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-414-3300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casey, IL

Sources for this page

Verify at the official NPI Registry.