Embassy Madison Management, LLC
Organization Active NPI Skilled Nursing Facility · Madison, OH
NPI 1487981536 · NPPES record last updated Dec 8, 2009
Key facts
- NPI
- 1487981536
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 6263 (OH)
- Legal business name
- EMBASSY MADISON MANAGEMENT, LLC
- Practice address
- 7600 S Ridge Rd
Madison, OH 44057-9746 - Phone
- (440) 428-1492
- Fax
- (440) 428-8698
- NPI assigned
- Nov 11, 2009
- Organization subpart
- No
Authorized official
- Name
- Hayley B Williams
- Title
- Attorney
- Phone
- (216) 706-3864
Owners & managing parties with NPI records 1
-
Shreeniwas Lele, MD
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Facilities with the same owner 34
Practitioners 1
-
Shreeniwas Lele, MD
Medicare Care Compare: Nursing home
- Listed as
- Madison Health Care
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 31, 1974
- Medicare certification status
- Active
- Certified beds
- 125 · 98.1 residents per day on average
- Chain
- Embassy Healthcare
- Penalties (3 years)
- 1 · fines totaling $109,991
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Skilled nursing facility certification: CCN 365306
- Legal name
- EMBASSY MADISON MANAGEMENT, LLC
- Doing business as
- MADISON HEALTH CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 31, 1974
- Last certification
- Mar 13, 2025
- Beds
- 125
- Ownership / control type
- Corporation
- Multi-facility organization
- Embassy Healthcare
- Most recent change of ownership
- Nov 1, 2009
- Organization structure
- Corporation · Proprietary
- Incorporated
- Aug 27, 2009 in OH
- Enrollment address
- 7600 South Ridge Rd
Madison, OH 44057-9746 - Nursing home name
- MADISON HEALTH CARE
- Affiliated entity
- EMBASSY HEALTHCARE
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Ah Dynasty LLC |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Heritage Employment Services, LLC |
Operational/Managerial Control | Jan 1, 2020 | |
| Adp of the SNF | May 22, 2025 | ||
| Kayla Jean Cerjan |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Shreeniwas Lele |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| George S. Repchick 2020 Family Dynasty Trust |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Aaron Handler Family Dynasty Trust |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Aaron B Handler |
Corporate Officer |
Nov 1, 2009 | 50% |
| Operational/Managerial Control | Nov 1, 2009 | ||
| Indirect Ownership Interest | Nov 1, 2009 | 50% | |
| George S. Repchick |
Corporate Officer |
Jan 1, 2020 | 50% |
| Operational/Managerial Control | Jan 1, 2020 | ||
| Embassy Healthcare Management Inc |
Operational/Managerial Control | Jan 1, 2020 | |
| Adp of the SNF | May 22, 2025 | ||
| 2020 GSR Dynasty LLC |
Indirect Ownership Interest | Jan 1, 2020 | 50% |
| Embassy Healthcare Holdings Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2020 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091215000635 | OH | Part a Provider - Skilled Nursing Facility | 1658411038 | Practice locations: Madison, OH |
National Provider Directory
- Tax ID family
- Embassy Madison Management LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 6263 | OH | Yes |
Addresses
Primary practice location
7600 S Ridge Rd
Madison, OH 44057-9746
Mailing address
24579 Broadway Ave
Oakwood Village, OH 44146-6338
Phone (440) 658-1458
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2990054 | Medicaid | OH |
Other names
- Madison Health Care
Other providers in Madison, OH
- Drayer Physical Therapy Institute LLC
- Pamela Belle Dustman
- Dva Healthcare Renal Care Inc
- Eastwood Residential Living, Inc.
- Larry Edward Ede
- Embassy Madison Management, LLC
- Stephanie A Evanoff
- Olivia Fait
- Robyn Leigh Feldman
- Megan Ferritto
All providers in Madison, OH · Skilled Nursing Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.