Active NPI
Stoneridge Retirement Living
- Skilled Nursing Facility
- Myerstown, PA
National Provider Identifier
1508882002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 055702
- Legal business name
- STONERIDGE RETIREMENT LIVING
- Practice address
- 450 East Lincoln Ave
Myerstown, PA 17067-2239 - Phone
- (717) 866-3200
- Fax
- (717) 866-7778
- NPI assigned
- Jul 15, 2006
- 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
- Mr. Steven J. Reiter, CPA
- Title
- President/Ceo
- Phone
- (717) 866-3200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 055702 | PA | Primary |
Addresses
Primary practice location
450 East Lincoln Ave
Myerstown, PA 17067-2239
Mailing address
440 E Lincoln Ave
Myerstown, PA 17067-2239
Phone (717) 866-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA1007512800004 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080527000204 | PA | Part A Provider - Skilled Nursing Facility | 1052480472 | Practice locations: Myerstown, PA |
Skilled nursing facility certification: CCN 395927
- Legal name
- STONERIDGE RETIREMENT LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 23, 1994
- Last certification
- Oct 3, 2024
- Beds
- 60
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Jan 7, 1929 in PA
- Enrollment address
- 440 E Lincoln Ave
Myerstown, PA 17067-2239 - Nursing home name
- STONERIDGE POPLAR RUN
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Stoneridge Poplar Run
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Feb 23, 1994
- Medicare certification status
- Active
- Certified beds
- 60
National Provider Directory
National Provider Directory- Tax ID family
- Stoneridge Poplar Run
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Myerstown, PA
- NPI 1467478941
Ownership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Ryan Casey | Corporate Officer | Jun 2, 2014 | |
| Jill Smith | Corporate Director | Jan 1, 2024 | |
| Trustee of the SNF | Jan 1, 2024 | ||
| Steven Reiter | Corporate Officer | May 16, 2008 | |
| Trustee of the SNF | May 16, 2008 | ||
| Robert J Pearlstein | Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Feb 20, 2025 | ||
| Cynthia Walters | Corporate Director | Jan 1, 2024 | |
| Scott Artz | Corporate Director | Jan 1, 2024 | |
| Trustee of the SNF | Jan 1, 2024 | ||
| April Gerber | Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Feb 20, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Plymouth Meeting, PA
- NPI 1598788689
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Plymouth Meeting, PA
- NPI 1598788689
Affiliated clinicians 3
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": "1152921600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478131200000",
"number": "1508882002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 E LINCOLN AVE",
"city": "MYERSTOWN",
"state": "PA",
"postal_code": "170672239",
"telephone_number": "717-866-3200",
"fax_number": "717-866-7778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 EAST LINCOLN AVE",
"city": "MYERSTOWN",
"state": "PA",
"postal_code": "170672239",
"telephone_number": "717-866-3200",
"fax_number": "717-866-7778"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STONERIDGE RETIREMENT LIVING",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-15",
"last_updated": "2016-11-03",
"status": "A",
"authorized_official_last_name": "REITER",
"authorized_official_first_name": "STEVEN",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "717-866-3200",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "PA",
"license": "055702",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MA1007512800004",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myerstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.