Active NPI
Good Samaritan Lutheran Health Care Center, Inc.
- Skilled Nursing Facility
- Delmar, NY
National Provider Identifier
1407976871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0151300N
- Legal business name
- GOOD SAMARITAN LUTHERAN HEALTH CARE CENTER, INC.
- Practice address
- 125 Rockefeller Rd
Delmar, NY 12054-2221 - Phone
- (518) 439-8116
- Fax
- (518) 475-1579
- NPI assigned
- Mar 30, 2007
- 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
- Rafi Lehmann
- Title
- Administrator
- Phone
- (518) 439-8116
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0151300N | NY | Primary |
Addresses
Primary practice location
125 Rockefeller Rd
Delmar, NY 12054-2221
Mailing address
4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00308567 | Medicaid | NY |
Other names 1
- Delmar Center for Rehabilitation and Nursing
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100831000370 | NY | Part A Provider - Skilled Nursing Facility | 1658495411 | Practice locations: Delmar, NY |
Skilled nursing facility certification: CCN 335735
- Legal name
- GOOD SAMARITAN LUTHERAN HEALTH CARE CENTER INC
- Doing business as
- BETHLEHEM COMMONS CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 18, 1991
- Last certification
- Jan 23, 2025
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 13, 1972 in NY
- Enrollment address
- 125 Rockefeller Rd
Delmar, NY 12054-2221 - Nursing home name
- DELMAR CENTER FOR REHABILITATION AND NURSING
- Affiliated entity
- CENTERS HEALTH CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Delmar Center for Rehabilitation and Nursing
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Dec 18, 1991
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Centers Health Care
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 20
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 |
|---|---|---|---|
| John G Shane | Corporate Director | Jan 1, 2011 | |
| Other | Jan 1, 2011 | ||
| John F Ruth | Corporate Director | Jan 1, 1999 | |
| Other | Jan 1, 1999 | ||
| Good Samaritan Lutheran Health Care Center Inc | 5% Or Greater Direct Ownership Interest | Feb 1, 1975 | 100% |
| Lynette E Taylor | Corporate Director | Jan 1, 1999 | |
| Other | Jan 1, 1999 | ||
| Arthur R Upright | Corporate Officer | Jan 1, 2000 | |
| Corporate Director | Jan 1, 2000 | ||
| Other | Jan 1, 2000 | ||
| Annette M Ball | Corporate Director | Dec 19, 2013 | |
| Other | Dec 19, 2013 | ||
| Barbara J Raczak | Corporate Director | Dec 19, 2013 | |
| Other | Dec 19, 2013 | ||
| Frank R Tripodi | Corporate Officer | Dec 15, 2010 | 100% |
| Corporate Director | Dec 15, 2010 | ||
| Other | Dec 15, 2010 | ||
| Christopher J Jones | Corporate Director | Dec 19, 2013 | |
| Other | Dec 19, 2013 | ||
| Peter M Mazer | Corporate Director | Jan 1, 2005 | |
| Other | Jan 1, 2005 | ||
| Karen S Woodcock | W-2 Managing Employee | Sep 5, 2014 | 100% |
| The Lutheran Care Network Inc | 5% Or Greater Indirect Ownership Interest | Dec 13, 1972 | 100% |
| Laraine Fellegara | Corporate Officer | Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2010 | ||
| Other | Jan 1, 2010 | ||
| Kenneth Rozenberg | Corporate Director | Jun 1, 2020 | |
| Louis J Albano | Corporate Director | Sep 1, 2015 | |
| Other | Sep 1, 2015 | ||
| Anna Mae Knowles | Corporate Director | Dec 19, 2013 | |
| Other | Dec 19, 2016 | ||
| Robert E Hartwell | Corporate Director | Sep 1, 2015 | |
| Other | Sep 1, 2015 | ||
| Alec C Davis | Corporate Director | Jan 1, 1995 | |
| Other | Jan 1, 1995 | ||
| Richard J Olson | Corporate Director | Jan 1, 1999 | |
| Other | Jan 1, 1999 | ||
| Brian E McWeeney | Corporate Director | Jan 1, 2005 | |
| Other | Jan 1, 2005 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Schenectady, NY
- NPI 1477535458
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Schenectady, NY
- NPI 1851302137
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604966400000",
"number": "1407976871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4770 WHITE PLAINS RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104701104",
"telephone_number": "718-931-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 ROCKEFELLER RD",
"city": "DELMAR",
"state": "NY",
"postal_code": "120542221",
"telephone_number": "518-439-8116",
"fax_number": "518-475-1579"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOOD SAMARITAN LUTHERAN HEALTH CARE CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-30",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A",
"authorized_official_last_name": "LEHMANN",
"authorized_official_first_name": "RAFI",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "518-439-8116"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "0151300N",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00308567",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Delmar Center for Rehabilitation and Nursing",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Delmar, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.