NPIMap

Organization Active NPI

St. Joseph's Bluffs Nursing and Rehab LLC

Doing business as Heisinger Bluffs Healthcare Western Campus

  • Skilled Nursing Facility
  • Jefferson City, MO
National Provider Identifier
1558084285
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ST. JOSEPH'S BLUFFS NURSING AND REHAB LLC
Doing business as
Heisinger Bluffs Healthcare Western Campus
Practice address
1306 W Main St
Jefferson City, MO 65109-1356
Phone
(573) 635-0166
NPI assigned
Sep 19, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Elazar Fischer
Title
Manager
Phone
(617) 895-9122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1306 W Main St
Jefferson City, MO 65109-1356

Mailing address

1135 E Veterans Hwy Ste 1
Jackson, NJ 08527-5090

Other names 1

  • Heisinger Bluffs Healthcare Western Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221107002939 MO Part A Provider - Skilled Nursing Facility 0840667671 Practice locations: Jefferson City, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558084285. Details of each certification follow.

Skilled nursing facility certification: CCN 265837

Legal name
ST JOSEPHS BLUFFS NURSING AND REHAB LLC
Doing business as
HEISINGER BLUFFS HEALTHCARE WESTERN CAMPUS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 10, 2010
Last certification
Oct 18, 2024
Beds
69
Ownership / control type
Limited Liability Corporation
Multi-facility organization
GREENTREE HEALTHCARE MANAGEMENT
Most recent change of ownership
Oct 1, 2022
Organization structure
LLCProprietary
Incorporated
Sep 13, 2022 in MO
Enrollment address
1306 W Main St
Jefferson City, MO 65109-1356
Nursing home name
HEISINGER BLUFFS HEALTHCARE WESTERN CAMPUS
Affiliated entity
GREEN TREE HEALTH MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heisinger Bluffs Healthcare Western CampusCCN 265837 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 10, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6960.1 residents per day on average
Chain
Green Tree Health Management8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1070106Heisinger Bluffs Healthcare Western Campus1306 West Main Street, Jefferson City, MO 65109Certificate of waiverJun 20, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
SJ Family Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Oct 1, 2022 21%
HB Operations Holdco LLC Organization, Jackson, NJ Holding company 5% Or Greater Direct Ownership Interest Oct 1, 2022 100%
Ads Capital Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Oct 1, 2022 21%
1026 Enterprises II, LLC Organization, Lakewood, NJ LLC 5% Or Greater Indirect Ownership Interest Feb 15, 2023 40%
SJ Healthcare Capital LLC Organization, Jackson, NJ LLC 5% Or Greater Indirect Ownership Interest Feb 15, 2023 22.63%
PC8 Capital Group LLC Organization, Dover, DE LLC 5% Or Greater Indirect Ownership Interest Feb 15, 2023 22.63%
Elazar Fischer Individual 5% Or Greater Indirect Ownership InterestAuthorized Official Oct 1, 2022 7.5%
Corporate OfficerAuthorized Official Oct 1, 2022 100%
Corporate DirectorAuthorized Official Oct 1, 2022 100%
10-26 Nationwide TR Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Feb 15, 2023 38%
Stacie McIntire Individual W-2 Managing EmployeeExecutive Director Oct 1, 2022 100%
MBM 2016 Family Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Feb 15, 2023 6.25%

Facilities with the same owner 45

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

View all 45

Practitioners & affiliated clinicians

Practitioners 2

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 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": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1558084285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 E VETERANS HWY STE 1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085275090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 W MAIN ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091356",
            "telephone_number": "573-635-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S BLUFFS NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "ELAZAR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-895-9122"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heisinger Bluffs Healthcare Western Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.