Organization Active NPI

RJ Meridian Care Alta Vista LLC

  • Skilled Nursing Facility
  • San Antonio, TX
National Provider Identifier
1396073474
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RJ MERIDIAN CARE ALTA VISTA LLC
Practice address
616 W Russell PL
San Antonio, TX 78212-3658
Phone
(281) 465-0636
Fax
(281) 465-0748
NPI assigned
Nov 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Mr. Ramiro G Lozano
Title
Managing Director
Phone
(281) 465-0636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

616 W Russell PL
San Antonio, TX 78212-3658

Mailing address

25009 Oakhurst Dr
Spring, TX 77386-1975
Phone (281) 465-0636

Other identifiers 1

IdentifierTypeStateIssuer
4473MedicaidTX

Other names 1

  • Meridian Care Monte Vista Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100526000887 TX Part A Provider - Skilled Nursing Facility 2567591761 Practice locations: San Antonio, TX

Skilled nursing facility certification: CCN 455450

Legal name
RJ MERIDIAN CARE ALTA VISTA LLC
Doing business as
MERIDIAN CARE MONTE VISTA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 1, 1978
Last certification
Nov 6, 2024
Beds
106
Ownership / control type
Individual
Organization structure
LLCProprietary
Enrollment address
616W Russell PL
San Antonio, TX 78212-3658
Nursing home name
MERIDIAN CARE MONTE VISTA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Meridian Care Monte VistaCCN 455450
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Jan 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10657.2 residents per day on average
Penalties (3 years)
2Fines totaling $23,438

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
45D0678705Meridian Care Monte Vista616 W Russell, San Antonio, TX 78212Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Jay Balentine Individual 5% Or Greater Direct Ownership Interest Jan 8, 2010 50%
Corporate Officer Jan 8, 2010 50%
Adp of the SNF Jan 8, 2010
Direct Ownership Interest Jan 8, 2010 50%
Kimberly Glisczinski Individual Operational/Managerial Control May 19, 2022
Adp of the SNF Jan 30, 2025
Wesam Sabri Aziz Individual Operational/Managerial Control Jun 1, 2023
Adp of the SNF Jan 30, 2025
Ramiro G Lozano Individual 5% Or Greater Direct Ownership Interest Jan 8, 2010 50%
Corporate OfficerPresident, Ceo Nov 30, 2009 50%
Adp of the SNF Jan 8, 2010
Direct Ownership Interest Jan 8, 2010 50%
Pamela Nienaber Individual Operational/Managerial Control Feb 10, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1396073474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25009 OAKHURST DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773861975",
            "telephone_number": "281-465-0636",
            "fax_number": "281-465-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W RUSSELL PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782123658",
            "telephone_number": "281-465-0636",
            "fax_number": "281-465-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RJ MERIDIAN CARE ALTA VISTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "LOZANO",
        "authorized_official_first_name": "RAMIRO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "281-465-0636",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4473",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Care Monte Vista",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meridian Care Monte Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.