Oconto Falls Nursing and Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

OCONTO FALLS NURSING AND REHAB LLC

Doing business as

Meadowbrook at Oconto Falls

Practice address

100 E Highland Dr
Oconto Falls, WI 54154-1001

Phone

(920) 848-3272

NPI assigned

Sep 15, 2019

Last updated

Feb 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rostislav Pukshansky

Title

Partner

Phone

(847) 942-7575

Specialties & licenses 1

Addresses

Other names 1

• Meadowbrook at Oconto Falls Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609426337. Details of each certification follow.

• CCN 525449 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525449

Legal name

OCONTO FALLS NURSING AND REHAB LLC

Doing business as

MEADOWBROOK AT OCONTO FALLS

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1989

Last certification

May 29, 2025

Beds

99

Ownership / control type

Corporation

Multi-facility organization

Synergy Senior Care

Most recent change of ownership

Dec 1, 2019

Organization structure

LLCProprietary

Incorporated

Sep 9, 2019 in WI

Enrollment address

100 E Highland Dr
Oconto Falls, WI 54154-1001

Nursing home name

MEADOWBROOK AT OCONTO FALLS

Affiliated entity

SYNERGY SENIOR CARE

Listed as

Meadowbrook at Oconto FallsCCN 525449 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Dec 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9961.4 residents per day on average

Chain

Synergy Senior Care5 facilities in the chain

Penalties (3 years)

2Fines totaling $43,234

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Stacee Lynn Goedtel Birr, DO

  • Family Medicine Physician
  • Appleton, WI
  • NPI 1295152189

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• BRF Nursing and Rehab LLC

  dba Meadowbrook at Black River Falls

  • Skilled Nursing Facility
  • Black River Falls, WI
  • NPI 1164072898

  Adp of the SNF

  CMS ownership

Facilities with the same owner 3

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

• Bloomer Nursing and Rehab LLC

  dba Meadowbrook at Bloomer

  • Skilled Nursing Facility
  • Bloomer, WI
  • NPI 1346890076

  Synergy Senior Care LLC

  CMS ownership
• BRF Nursing and Rehab LLC

  dba Meadowbrook at Black River Falls

  • Skilled Nursing Facility
  • Black River Falls, WI
  • NPI 1164072898

  Synergy Senior Care LLC

  CMS ownership
• Chetek Nursing and Rehab LLC

  dba Meadowbrook at Chetek

  • Skilled Nursing Facility
  • Chetek, WI
  • NPI 1982254611

  Synergy Senior Care LLC

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Matthew James Andreoli, MD

  • Family Medicine Physician
  • Oconto Falls, WI
  • NPI 1538621917

  Nursing home

  Care Compare affiliation
• Stacee Lynn Goedtel Birr, DO

  • Family Medicine Physician
  • Appleton, WI
  • NPI 1295152189

  Nursing home

  Care Compare affiliation
• Amy M Romandine Kratz, MD

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1023376910

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1609426337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 119",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "847-942-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E HIGHLAND DR",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541001",
            "telephone_number": "920-848-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCONTO FALLS NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-15",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "PUKSHANSKY",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "847-942-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowbrook at Oconto Falls",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meadowbrook at Oconto Falls",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Oconto Falls, WI
• Providers in Oconto Falls, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.

Verify at the official NPI Registry.