NPIMap

Organization Active NPI

Edgewood Manor Rehabilitation and Healthcare Center LLC

  • Skilled Nursing Facility
  • Port Clinton, OH
National Provider Identifier
1548746159
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EDGEWOOD MANOR REHABILITATION AND HEALTHCARE CENTER LLC
Practice address
1330 Fulton St
Port Clinton, OH 43452-9297
Phone
(732) 372-9636
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
Moshe Weintraub
Title
Coo
Phone
(732) 372-9636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1330 Fulton St
Port Clinton, OH 43452-9297

Mailing address

14 Oliver St
Lakewood, NJ 08701-2339

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181119002225 OH Part A Provider - Skilled Nursing Facility 6901150432 Practice locations: Port Clinton, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548746159. Details of each certification follow.

Skilled nursing facility certification: CCN 365489

Legal name
EDGEWOOD MANOR REHABILITATION AND HEALTHCARE CENTER LLC
Doing business as
EDGEWOOD MANOR REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 19, 1980
Last certification
Jul 8, 2024
Beds
80
Ownership / control type
Partnership
Multi-facility organization
CROWN HEALTHCARE
Most recent change of ownership
Sep 20, 2018
Organization structure
LLCProprietary
Enrollment address
1330 Fulton St
Port Clinton, OH 43452-9297
Nursing home name
EDGEWOOD MANOR REHABILITATION & HEALTHCARE CENTER
Affiliated entity
CROWN HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edgewood Manor Rehabilitation & Healthcare CenterCCN 365489 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
May 19, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8068.5 residents per day on average
Chain
Crown Healthcare Group9 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Toms River, NJ LLC Adp of the SNF Dec 1, 2024
Kevin Daubenmire Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 25%
Operational/Managerial Control Sep 20, 2018
Managing Control - Governing BodyManger of the Manager Sep 20, 2018
Adp of the SNF Sep 20, 2018
Individual Indirect Ownership Interest Sep 20, 2018 1.14%
Rugen Alda Individual Operational/Managerial Control Jul 27, 2023
Adp of the SNF Jun 30, 2025
Benjamin Shkop Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 11.25%
Zissy Basch Individual Trustee of the SNF Sep 20, 2018
Mrs Family Trust Organization, Lakewood, NJ Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 14.41%
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Mozart Realty Ventures LLC Organization, Lincolnwood, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 20, 2018 22.5%
Organization, Toms River, NJ LLC Adp of the SNF May 1, 2024
Meir Singer Individual Corporate OfficerPresident Nov 5, 2018
Trustee of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 1.13%
Yisrael Friedman Individual Trustee of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 1.14%
Crown I TBD Holdco LLC Organization, Toms River, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Oct 9, 2021 100%
Mdatas Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 20, 2018 15.17%
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Crown Ohio Holdco Inc Organization, Lakewood, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 20, 2018 100%
Direct Ownership Interest Sep 20, 2018 100%
Organization, Toms River, NJ Investment firm Adp of the SNF Dec 16, 2022
Fejcc Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Sep 20, 2018
Adp of the SNF Sep 20, 2018
Indirect Ownership Interest Sep 20, 2018 21.53%
Individual Adp of the SNF Feb 28, 2025
Capital Finance LLC Organization, Baltimore, MD LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Sep 20, 2018
Operational/Managerial Control Sep 20, 2018
Organization, Toms River, NJ LLC Adp of the SNF Sep 20, 2018
Organization, Toms River, NJ LLC Adp of the SNF Jun 30, 2025
Moshe Weintraub Individual 5% Or Greater Indirect Ownership Interest Sep 20, 2018 7%
Franklin Swinehart Individual Operational/Managerial Control Feb 28, 2025

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 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1548746159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 OLIVER ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434529297",
            "telephone_number": "732-372-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD MANOR REHABILITATION AND HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "WEINTRAUB",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "732-372-9636"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.