NPIMap

Organization Active NPI

Heritage Park Nursing Center LLC

Doing business as Heritage Park Nursing Center

  • Skilled Nursing Facility
  • Bradenton, FL
National Provider Identifier
1427783752
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HERITAGE PARK NURSING CENTER LLC
Doing business as
Heritage Park Nursing Center
Practice address
2302 59TH St W
Bradenton, FL 34209-7018
Phone
(941) 792-8480
Fax
(941) 794-8905
NPI assigned
Jul 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Mathew Varghese
Title
Member
Phone
(917) 817-3530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2302 59TH St W
Bradenton, FL 34209-7018

Mailing address

2302 59TH St W
Bradenton, FL 34209-7018
Phone (941) 792-8480

Other identifiers 1

IdentifierTypeStateIssuer
1226095OtherFLLICENSE

Other names 1

  • Heritage Park Nursing Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://heritageparkcare.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301001624 FL Part A Provider - Skilled Nursing Facility 7810360492 Practice locations: Bradenton, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427783752. Details of each certification follow.

Skilled nursing facility certification: CCN 105529

Legal name
HERITAGE PARK NURSING CENTER LLC
Doing business as
HERITAGE PARK NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 23, 1986
Last certification
Oct 19, 2023
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jul 7, 2022 in FL
Enrollment address
2302 59TH St W
Bradenton, FL 34209-7018

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Park Health Center by HarborviewCCN 105529 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 23, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120112.8 residents per day on average
Penalties (3 years)
1Fines totaling $4,475

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Heritage Park Nursing Member LLC Organization, Bradenton, FL Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 7, 2022 100%
Mayer Fischel Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
ZBL-18 LLC Organization, Brooklyn, NY Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
Kimberly Brennick Individual W-2 Managing EmployeeAdministrator Oct 8, 2022 100%
Heritage Park Nursing Center LLC Organization, Bradenton, FL Created for acquisition, LLC, Holding company 5% Or Greater Direct Ownership Interest Oct 8, 2022 100%
Benjamin Landa Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 75%
Corporate Officer Oct 8, 2022 100%
Tampa 3 Opco Partners LLC Organization, Woodmere, NY Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 100%
Flnho Capital Group LLC Organization, Mineola, NY LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 75%

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1427783752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097018",
            "telephone_number": "941-792-8480",
            "fax_number": "941-794-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097018",
            "telephone_number": "941-792-8480",
            "fax_number": "941-794-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE PARK NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-817-3530"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1226095",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://heritageparkcare.com/",
            "affiliation": "N",
            "address_1": "2302 59th St W",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342097018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heritage Park Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.