Active NPI
530 Macoby Street Operations LLC
- Skilled Nursing Facility
- Pennsburg, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 162402
- Legal business name
- 530 MACOBY STREET OPERATIONS LLC
- Practice address
- 530 Macoby St
Pennsburg, PA 18073-1112 - Phone
- (215) 679-8076
- Fax
- (215) 679-3117
- NPI assigned
- Nov 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael T Berg
- Title
- Secretary
- Phone
- (610) 444-6350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 162402 | PA | Primary |
Addresses
Primary practice location
530 Macoby St
Pennsburg, PA 18073-1112
Mailing address
101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1025714500001 | Medicaid | PA |
Other names 1
- Pennsburg Manor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080305000378 | PA | Part A Provider - Skilled Nursing Facility | 1052496767 | Practice locations: Pennsburg, PA |
Skilled nursing facility certification: CCN 395555
- Legal name
- 530 MACOBY STREET OPERATIONS LLC
- Doing business as
- PENNSBURG MANOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1982
- Last certification
- May 6, 2025
- Beds
- 120
- Ownership / control type
- Partnership
- Multi-facility organization
- GENESIS HEALTHCARE CORPORATION
- Organization structure
- LLC
- Incorporated
- Aug 21, 2007 in PA
- Enrollment address
- 530 Macoby Street
Pennsburg Manor
Pennsburg, PA 18073-1112 - Nursing home name
- PENNSBURG MANOR
- Affiliated entity
- GENESIS HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pennsburg Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Nov 1, 1982
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Genesis Healthcare
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 20
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| HCCF Management Group XI LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2011 | 21% |
| Gen Operations I LLC | 5% Or Greater Indirect Ownership Interest | Apr 1, 2011 | 100% |
| Stacy Omar | Operational/Managerial Control | May 30, 2001 | |
| Adp of the SNF | Mar 14, 2025 | ||
| Gen Operations II LLC | 5% Or Greater Indirect Ownership Interest | Apr 1, 2011 | 100% |
| FC-Gen Operations Investment LLC | 5% Or Greater Indirect Ownership Interest | Apr 1, 2011 | 100% |
| Adp of the SNF | Jan 1, 2019 | ||
| Sundance Rehabilitation Holdco Inc | 5% Or Greater Indirect Ownership Interest | Jan 1, 2016 | 100% |
| Genesis Operations IV LLC | 5% Or Greater Direct Ownership Interest | Feb 2, 2015 | 100% |
| Genesis Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Apr 1, 2011 | 100% |
| Sun Healthcare Group Inc | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Welltower Op, LLC | 5% Or Greater Indirect Ownership Interest | Jan 2, 2022 | 5.7% |
| Arnold M Whitman | 5% Or Greater Indirect Ownership Interest | Dec 31, 2011 | 21% |
| Genesis Healthcare Inc | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
| Zac Properties XI LLC | 5% Or Greater Indirect Ownership Interest | Dec 31, 2011 | 12% |
| Steven E Fishman | 5% Or Greater Indirect Ownership Interest | Dec 31, 2011 | 11.4% |
| Adp of the SNF | Jan 1, 2019 | ||
| Michael T Berg | Corporate Officer | Dec 1, 2012 | 100% |
| Ashley McBrearty Hindson | Operational/Managerial Control | Jan 1, 2019 | |
| Adp of the SNF | Mar 14, 2025 | ||
| GHC Holdings LLC | 5% Or Greater Indirect Ownership Interest | Apr 1, 2011 | 100% |
| Genesis Holdings LLC | 5% Or Greater Indirect Ownership Interest | Feb 2, 2015 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Hospitalist Physician
- Allentown, PA
- NPI 1467894691
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 178
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Lancaster, PA
- NPI 1467162172
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Dallastown, PA
- NPI 1336859040
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Jersey Shore, PA
- NPI 1063122778
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Quakertown, PA
- NPI 1588846893
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Chambersburg, PA
- NPI 1780394494
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Philadelphia, PA
- NPI 1346422748
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, Genesis Operations IV LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group I
-
- Skilled Nursing Facility
- Wallingford, PA
- NPI 1417667130
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Wyncote, PA
- NPI 1639351943
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Welltower Op, LLC, Zac
-
- Skilled Nursing Facility
- Hamburg, PA
- NPI 1356523666
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Camp Hill, PA
- NPI 1417667163
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
-
- Skilled Nursing Facility
- Norristown, PA
- NPI 1851573174
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Welltower Op, LLC, Zac
-
- Skilled Nursing Facility
- York, PA
- NPI 1073223798
FC-Gen Operations Investment LLC, Gen Operations I LLC, Gen Operations II LLC, Genesis Healthcare Inc, Genesis Healthcare LLC, Genesis Holdings LLC, GHC Holdings LLC, HCCF Management Group XI LLC, Sun Healthcare Group Inc, Sundance Rehabilitation
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- Center Valley, PA
- NPI 1477500940
-
- Hospitalist Physician
- Allentown, PA
- NPI 1467894691
Affiliated clinicians 2
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": "1196208000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759708800000",
"number": "1497937700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E STATE ST",
"city": "KENNETT SQUARE",
"state": "PA",
"postal_code": "193483109",
"telephone_number": "610-925-4436",
"fax_number": "610-925-4351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 MACOBY ST",
"city": "PENNSBURG",
"state": "PA",
"postal_code": "180731112",
"telephone_number": "215-679-8076",
"fax_number": "215-679-3117"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "530 MACOBY STREET OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-28",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A",
"authorized_official_last_name": "BERG",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "610-444-6350"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "PA",
"license": "162402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1025714500001",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pennsburg Manor",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pennsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.