NPIMap

Organization Active NPI

King David at Autumn Lake LLC

  • Skilled Nursing Facility
  • Baltimore, MD
National Provider Identifier
1437693785
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
03024 Issued in MD
Legal business name
KING DAVID AT AUTUMN LAKE LLC
Practice address
4204 Old Milford Mill Rd
Baltimore, MD 21208-6031
Phone
(410) 486-1500
NPI assigned
Dec 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Authorized official

Name
Mr. Aryeh Stern
Title
Managing Member
Phone
(732) 358-6883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 03024 MD Primary

Addresses

Primary practice location

4204 Old Milford Mill Rd
Baltimore, MD 21208-6031

Mailing address

4204 Old Milford Mill Rd
Baltimore, MD 21208-6031
Phone (410) 486-1500

Other names 1

  • King David Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170324001957 MD Part A Provider - Skilled Nursing Facility 7315222841 Practice locations: Baltimore, MD

Skilled nursing facility certification: CCN 215022

Legal name
KING DAVID AT AUTUMN LAKE LLC
Doing business as
KING DAVID NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Apr 30, 2021
Beds
100
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Autumn Lake Healthcare
Organization structure
LLCProprietary
Enrollment address
4204 Old Milford Mill Rd
Baltimore, MD 21208-6031
Nursing home name
KING DAVID NURSING AND REHABILITATION CENTER
Affiliated entity
AUTUMN LAKE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
King David Nursing and Rehabilitation CenterCCN 215022
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
100103.0 residents per day on average
Chain
Autumn Lake Healthcare59 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
King David at Autumn Lake LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
King David Equities LLC Organization, Brooklyn, NY Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 1, 2017 15%
Adp of the SNF Sep 1, 2017
4260 Group LLC Organization, Howell, NJ Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2017 10%
Adp of the SNF Sep 1, 2017
Daniel Donaty Individual Operational/Managerial Control Jan 17, 2023
Adp of the SNF Jan 17, 2023
Aryeh Stern Individual 5% Or Greater Direct Ownership Interest Sep 1, 2017 60%
Adp of the SNF Sep 1, 2017
The Markstein Group LLC Organization, Howell, TX Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2017 10%
Adp of the SNF Sep 1, 2017
Organization, Brooklyn, NY Adp of the SNF Jun 15, 2025
Narender Bharaj Individual Operational/Managerial Control Jul 23, 2022
Adp of the SNF Jul 23, 2022
Mark Schwartz Individual Corporate OfficerCoo Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Organization, Brooklyn, NY LLC Adp of the SNF Jun 15, 2025
King David Realty LLC Organization, Howell, NJ Created for acquisition, LLC, For-profit 5% Or Greater Mortgage Interest Sep 1, 2017 100%
Adp of the SNF Sep 1, 2017
Morris Meisels Individual Adp of the SNF Sep 1, 2017
Direct Ownership Interest Sep 1, 2017 5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 5

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

Affiliated clinicians 4

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": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1437693785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 OLD MILFORD MILL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086031",
            "telephone_number": "410-486-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 OLD MILFORD MILL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086031",
            "telephone_number": "410-486-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING DAVID AT AUTUMN LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "ARYEH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "732-358-6883",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "03024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King David Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.