NPIMap

Organization Active NPI

Goldenstar Healthcare, Inc.

  • Skilled Nursing Facility
  • Riverside, CA
National Provider Identifier
1467165993
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GOLDENSTAR HEALTHCARE, INC.
Practice address
11162 Palm Terrace LN
Riverside, CA 92505-2338
Phone
(951) 687-7330
NPI assigned
Dec 29, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

11162 Palm Terrace LN
Riverside, CA 92505-2338

Mailing address

11162 Palm Terrace LN
Riverside, CA 92505-2338
Phone (951) 687-7330

Other names 1

  • Palm Terrace Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0NhinService/XDRReesponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230518002760 CA Part A Provider - Skilled Nursing Facility 2769848647 Practice locations: Riverside, CA

Skilled nursing facility certification: CCN 555365

Legal name
GOLDENSTAR HEALTHCARE INC
Doing business as
PALM TERRACE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 21, 1989
Last certification
May 16, 2025
Beds
75 (71 certified)
Ownership / control type
Corporation
Most recent change of ownership
Feb 1, 2023
Organization structure
CorporationProprietary
Incorporated
Nov 8, 2022 in NV
Enrollment address
11162 Palm Terrace LN
Riverside, CA 92505-2338
Nursing home name
PALM TERRACE CARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Palm Terrace Care CenterCCN 555365
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 21, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7167.9 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Flagstone Healthcare Central LLC Organization, San Juan Capistrano, CA LLC 5% Or Greater Direct Ownership Interest Nov 8, 2022 100%
Matthew Scott Individual Corporate OfficerPresident Goldenstar Healthcare Feb 1, 2023
Ryan Leet Individual Operational/Managerial ControlAdministrator Feb 1, 2023
Managing Control - Governing BodyAdministrator Feb 1, 2023
Adp of the SNF Jun 29, 2025
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Feb 1, 2023 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Oct 31, 2022
Adam Willits Individual Corporate DirectorDirector Goldenstar Healthcare, Inc Feb 1, 2023
Ami Sato Individual Corporate OfficerTreasurer Goldenstar Healthcare Sep 9, 2024
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Soon Burnam Individual Corporate OfficerSecretary Goldenstar Healthcare Nov 8, 2022
Qais Ayouby Individual Operational/Managerial Control Dec 1, 2023
Managing Control - Governing BodyMedical Director Dec 1, 2023
Adp of the SNF Jun 29, 2025

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1467165993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11162 PALM TERRACE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052338",
            "telephone_number": "951-687-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11162 PALM TERRACE LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052338",
            "telephone_number": "951-687-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDENSTAR HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0NhinService/XDRReesponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Palm Terrace Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.