NPIMap

Organization Active NPI

Petoskey Opco, LLC

  • Skilled Nursing Facility
  • Petoskey, MI
National Provider Identifier
1477933455
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PETOSKEY OPCO, LLC
Practice address
1500 Spring St
Petoskey, MI 49770-9295
Phone
(231) 347-5500
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Marcella Graf
Title
Cfo
Phone
(224) 470-2044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1500 Spring St
Petoskey, MI 49770-9295

Mailing address

3755 Chase Ave
Skokie, IL 60076-4008
Phone (847) 440-2660

Other identifiers 1

IdentifierTypeStateIssuer
1477933455MedicaidMI

Other names 1

  • The Villa at the Bay Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160304000007 MI Part A Provider - Skilled Nursing Facility 1557667375 Practice locations: Petoskey, MI

Skilled nursing facility certification: CCN 235429

Legal name
PETOSKEY OPCO LLC
Doing business as
THE VILLA AT THE BAY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 25, 1983
Last certification
May 22, 2025
Beds
110
Ownership / control type
Corporation
Multi-facility organization
Omnia
Most recent change of ownership
Jul 1, 2015
Organization structure
LLCProprietary
Incorporated
Mar 30, 2015 in MI
Enrollment address
1500 Spring St
Petoskey, MI 49770-9295
Nursing home name
THE VILLA AT THE BAY
Affiliated entity
VILLA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Villa at the BayCCN 235429
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 25, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11076.5 residents per day on average
Chain
Villa Healthcare18 facilities in the chain
Penalties (3 years)
5Fines totaling $241,488

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
23D0381807Villa at the Bay, the1500 Spring St, Petoskey, MI 49770Certificate 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
Ashley McLenna Individual Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Yehoshua Baumol Individual Operational/Managerial Control Jul 1, 2023
Joseph B Singerman Individual Operational/Managerial Control Feb 20, 2025
Adp of the SNF Feb 20, 2025
Marcella Graf Individual Operational/Managerial Control Jul 1, 2023
Omnia Opco Holdings LLC Organization, Lincolnwood, IL Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2023 100%
Jonathan Aaron Individual Corporate Officer Jul 1, 2023

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 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 1

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": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1477933455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 CHASE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764008",
            "telephone_number": "847-440-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SPRING ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709295",
            "telephone_number": "231-347-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETOSKEY OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "GRAF",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "224-470-2044"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477933455",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "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": "The Villa at the Bay",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Villa at the Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.