Organization Active NPI

Hamilton Operator, LLC

Doing business as Preferred Care at Hamilton

  • Skilled Nursing Facility
  • Hamilton Square, NJ
National Provider Identifier
1467018978
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAMILTON OPERATOR, LLC
Doing business as
Preferred Care at Hamilton
Practice address
1501 State Highway 33
Hamilton Square, NJ 08690-1705
Phone
(609) 586-1114
NPI assigned
May 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(877) 567-0402

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X Primary
Respite Care 385H00000X

Addresses

Primary practice location

1501 State Highway 33
Hamilton Square, NJ 08690-1705

Mailing address

14C 53Rd St Ste 220
Brooklyn, NY 11232-2644
Phone (877) 567-0402

Other names 1

  • Preferred Care at Hamilton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191105000274 NJ Part A Provider - Skilled Nursing Facility 7719219187 Practice locations: Hamilton Square, NJ

Skilled nursing facility certification: CCN 315111A

Legal name
HAMILTON OPERATOR, LLC
Doing business as
PREFERRED CARE AT HAMILTON
Organization structure
LLCProprietary
Incorporated
Apr 11, 2019 in NJ
Enrollment address
1501 State Highway 33
Hamilton Square, NJ 08690-1705
Nursing home name
PREFERRED CARE AT HAMILTON
Affiliated entity
PREFERRED CARE

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
Dov Green Individual 5% Or Greater Indirect Ownership InterestOwner Sep 1, 2019
Boruch D Mermelstein Individual 5% Or Greater Indirect Ownership InterestOwner Sep 1, 2019
Samuel Stern Individual Corporate OfficerCfo Sep 1, 2019 10%
David Schnell Individual 5% Or Greater Indirect Ownership InterestOwner Sep 1, 2019
John Pilek Individual W-2 Managing EmployeeAdministrator Sep 1, 2019 90%
Hamilton Holdco, LLC Organization, Lakewood, NJ Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2019 100%

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1467018978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 STATE HIGHWAY 33",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086901705",
            "telephone_number": "609-586-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON OPERATOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preferred Care at Hamilton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamilton Square, NJ

Sources for this page

Verify at the official NPI Registry.