NPIMap

Organization Active NPI

Schaumburg Skilled Nursing Facility LLC

Doing business as Bella Terra Schaumburg

  • Skilled Nursing Facility
  • Schaumburg, IL
National Provider Identifier
1457934747
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SCHAUMBURG SKILLED NURSING FACILITY LLC
Doing business as
Bella Terra Schaumburg
Practice address
675 S Roselle Rd
Schaumburg, IL 60193-3100
Phone
(847) 352-5500
Fax
(847) 352-8592
NPI assigned
May 4, 2021
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Mordechay Ninio
Title
Cfo
Phone
(847) 676-5315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

675 S Roselle Rd
Schaumburg, IL 60193-3100

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 679-9797

Other names 1

  • Bella Terra Schaumburg Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210624000188 IL Part A Provider - Skilled Nursing Facility 5193126498 Practice locations: Schaumburg, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457934747. Details of each certification follow.

Skilled nursing facility certification: CCN 145678

Legal name
SCHAUMBURG SKILLED NURSING FACILITY LLC
Doing business as
BELLA TERRA SCHAUMBURG
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 28, 1990
Last certification
Nov 20, 2024
Beds
214
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
675 S Roselle Rd
Schaumburg, IL 60193-3100
Nursing home name
BELLA TERRA SCHAUMBURG
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bella Terra SchaumburgCCN 145678 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 28, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
214160.2 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
5Fines totaling $96,025

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
14D0857746Bella Terra Schaumburg675 S Roselle Rd, Schaumburg, IL 60193Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Mordechay Ninio Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 7.5%
Tbdmd Il, LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Jun 1, 2021
Daniel Garden Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 58.5%
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%
Jason Lee Individual W-2 Managing EmployeeAdministrator Jun 1, 2021
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%

Facilities with the same owner 84

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

View all 84

Practitioners & affiliated clinicians

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": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1457934747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933100",
            "telephone_number": "847-352-5500",
            "fax_number": "847-352-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHAUMBURG SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "NINIO",
        "authorized_official_first_name": "MORDECHAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-676-5315"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Terra Schaumburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bella Terra Schaumburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.