NPIMap

Organization Active NPI

Welltower Opco Group LLC

Doing business as Sunrise Assisted Living of Randolph

  • Assisted Living Facility
  • Randolph, NJ
National Provider Identifier
1568958882
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WELLTOWER OPCO GROUP LLC
Doing business as
Sunrise Assisted Living of Randolph
Practice address
648 Route 10
Randolph, NJ 07869-2012
Phone
(973) 328-1922
Fax
(973) 328-0577
NPI assigned
Jul 10, 2018
Organization subpart
Yes
Parent organization
WELLTOWER OPCO GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Mr. Tony J. Harris
Title
Senior Reimbursement Manager
Phone
(703) 854-0830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

648 Route 10
Randolph, NJ 07869-2012

Mailing address

648 Route 10
Randolph, NJ 07869-2012
Phone (973) 328-1922

Other names 1

  • Sunrise Assisted Living of Randolph Doing business as

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
31D2194549Sunrise Assisted Living of Randolph648 Route 10 West, Randolph, NJ 07869Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Welltower Opco Group LLC22 organizations share this tax ID, including this one
Part of
Welltower Opco Group LLC

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1568958882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 ROUTE 10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692012",
            "telephone_number": "973-328-1922",
            "fax_number": "973-328-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 ROUTE 10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692012",
            "telephone_number": "973-328-1922",
            "fax_number": "973-328-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLTOWER OPCO GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLTOWER OPCO GROUP LLC",
        "enumeration_date": "2018-07-10",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SENIOR REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "703-854-0830",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Assisted Living of Randolph",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.