Parkshore Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7001385N Issued in NY

Legal business name

PARKSHORE HEALTHCARE LLC

Practice address

1535 Rockaway Pkwy
Brooklyn, NY 11236-4001

Phone

(718) 927-6300

Fax

(718) 272-2166

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Barry Friedman

Title

Ceo

Phone

(718) 927-6300

Specialties & licenses 3

Addresses

Other identifiers 7

Other names 1

• Four Seasons Nursing & Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• FSNR Chha LLC

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1093367039

  Sold to, 2019-06-30

  CMS change of ownership

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1477554723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364001",
            "telephone_number": "718-927-6300",
            "fax_number": "718-272-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364001",
            "telephone_number": "718-927-6300",
            "fax_number": "718-272-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSHORE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-927-6300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "7001916L",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "7001641",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7001385N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPERATING CERTF. #",
            "identifier": "7001361N",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995779",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPER CERT# CHHA",
            "identifier": "7001641",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPERATING  CERT #",
            "identifier": "7001385N",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00843485",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFI",
            "identifier": "3227",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OPER CERT# LTHHCP",
            "identifier": "7001916L",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Seasons Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Elizabeth Parks, OTL
• Jessica Parks, L.AC.
• Parkshore Health Care LLC
• Parkshore Health Care LLC
• Parkshore Healthcare LLC
• Parkshore Home Health Care LLC
• Parkside Dental PC
• Parkside Dental PC
• Parkside Express Pharmacy, Inc.
• Parkside Medical Office, PLLC

• Skilled Nursing Facility in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.