Active NPI
Beach Terrace Care Center Inc
- Skilled Nursing Facility
- Long Beach, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2902303N
- Legal business name
- BEACH TERRACE CARE CENTER INC
- Practice address
- 640 W Broadway
Long Beach, NY 11561-2900 - Phone
- (516) 431-4400
- Fax
- (516) 431-1622
- NPI assigned
- Jun 28, 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. Martin Zwick
- Title
- Administrator
- Phone
- (516) 431-4400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2902303N | NY | Primary |
Addresses
Primary practice location
640 W Broadway
Long Beach, NY 11561-2900
Mailing address
640 W Broadway
Long Beach, NY 11561-2900
Phone (516) 431-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00309857 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071212000434 | NY | Part A Provider - Skilled Nursing Facility | 3779673934 | Practice locations: Long Beach, NY |
Skilled nursing facility certification: CCN 335024
- Legal name
- BEACH TERRACE CARE CENTER INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Jul 8, 2024
- Beds
- 182
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Enrollment address
- 640 W Broadway
Long Beach, NY 11561-2900 - Nursing home name
- BEACH TERRACE CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Beach Terrace Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 182
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0154213 | Beach Terrace Care Center | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Roman Koldayev | Operational/Managerial Control | Sep 1, 2018 | |
| Adp of the SNF | Sep 1, 2018 | ||
| Avraham M Weits | 5% Or Greater Direct Ownership Interest | Feb 17, 2017 | 40% |
| Operational/Managerial Control | Feb 17, 2017 | ||
| Adp of the SNF | Feb 21, 2017 | ||
| Robn Barkherdarzdeh | Operational/Managerial Control | Jun 5, 2023 | |
| Adp of the SNF | Jun 5, 2023 | ||
| Martin Zwick | 5% Or Greater Direct Ownership Interest | Dec 2, 1992 | 10% |
| Adp of the SNF | Dec 2, 1992 | ||
| Dorothy Rubin | 5% Or Greater Direct Ownership Interest | Aug 1, 1993 | 50% |
| Adp of the SNF | Dec 23, 2023 | ||
| Direct Ownership Interest | Aug 1, 1993 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Lawrence, NY
- NPI 1790766970
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- East Meadow, NY
- NPI 1699914234
-
- Family Medicine Physician
- Oceanside, NY
- NPI 1912984063
-
- Internal Medicine Physician
- Lawrence, NY
- NPI 1790766970
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1336164235
-
- Specialist
- Long Beach, NY
- NPI 1992871032
-
- Internal Medicine Physician
- Wyandanch, NY
- NPI 1194763920
Affiliated clinicians 4
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": "1151452800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1416873600000",
"number": "1508893025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 W BROADWAY",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612900",
"telephone_number": "516-431-4400",
"fax_number": "516-431-1622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 W BROADWAY",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612900",
"telephone_number": "516-431-4400",
"fax_number": "516-431-1622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEACH TERRACE CARE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-28",
"last_updated": "2014-11-25",
"status": "A",
"authorized_official_last_name": "ZWICK",
"authorized_official_first_name": "MARTIN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "516-431-4400",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NY",
"license": "2902303N",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00309857",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.