Active NPI
Care Connection Rahway LLC
- Skilled Nursing Facility
- Rahway, NJ
National Provider Identifier
1407247190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 12006L
- Legal business name
- CARE CONNECTION RAHWAY LLC
- Practice address
- 865 Stone St
Rahway, NJ 07065-2742 - Phone
- (877) 567-0402
- NPI assigned
- Feb 17, 2015
- 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
- Sam Stern
- Title
- Cfo
- Phone
- (718) 567-0400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 12006L | NJ | Primary |
Addresses
Primary practice location
865 Stone St
Rahway, NJ 07065-2742
Mailing address
14C 53Rd St
Brooklyn, NY 11232-2644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 315146 | Other | HORIZON BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160303000173 | NJ | Part A Provider - Skilled Nursing Facility | 8325344286 | Practice locations: Rahway, NJ |
Skilled nursing facility certification: CCN 315146
- Legal name
- CARE CONNECTION RAHWAY LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Nov 1, 1973
- Last certification
- Aug 23, 2024
- Beds
- 24
- Ownership / control type
- Individual
- Multi-facility organization
- Excelsior
- Organization structure
- LLC
- Incorporated
- Dec 2, 2013 in NJ
- Enrollment address
- 865 Stone Street
Rahway, NJ 07065-2742 - Nursing home name
- CARE CONNECTION RAHWAY
- Affiliated entity
- ALARIS HEALTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Care Connection Rahway
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Individual
- Certified
- Nov 1, 1973
- Medicare certification status
- Active
- Certified beds
- 24
- Chain
- Alaris Health
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
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 |
|---|---|---|---|
| Samuel Stern | Corporate Officer | Jan 30, 2015 | 10% |
| Diane Dwulet | W-2 Managing Employee | Jan 30, 2015 | 90% |
| Avery Eisenreich | 5% Or Greater Direct Ownership Interest | Jan 30, 2015 | 100% |
| Care Connection Rahway LLC | 5% Or Greater Direct Ownership Interest | Jan 30, 2015 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 8
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": "1424131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1523491200000",
"number": "1407247190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14C 53RD ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112322644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 STONE ST",
"city": "RAHWAY",
"state": "NJ",
"postal_code": "070652742",
"telephone_number": "877-567-0402"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARE CONNECTION RAHWAY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-17",
"last_updated": "2018-04-12",
"status": "A",
"authorized_official_last_name": "STERN",
"authorized_official_first_name": "SAM",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "718-567-0400"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NJ",
"license": "12006L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON BCBS",
"identifier": "315146",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rahway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.