Organization Active NPI

Concord Nursing Home, Inc.

  • Skilled Nursing Facility
  • Brooklyn, NY
National Provider Identifier
1619004827
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CONCORD NURSING HOME, INC.
Practice address
300 Madison St
Brooklyn, NY 11216-1509
Phone
(718) 636-7500
Fax
(718) 636-7518
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Eitan Nat, LNHA
Title
Administrator
Phone
(718) 636-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

300 Madison St
Brooklyn, NY 11216-1509

Mailing address

4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700

Other identifiers 1

IdentifierTypeStateIssuer
00314609MedicaidNY

Other names 1

  • Concord Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120118000290 NY Part A Provider - Skilled Nursing Facility 5890728505 Practice locations: Brooklyn, NY

Skilled nursing facility certification: CCN 335538

Legal name
CONCORD NURSING HOME, INC.
Doing business as
CONCORD NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1976
Last certification
Jul 26, 2024
Beds
140
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 14, 1971 in NY
Enrollment address
300 Madison Street
Brooklyn, NY 11216-1597
Nursing home name
CONCORD NURSING AND REHABILITATION CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Concord Nursing and Rehabilitation CenterCCN 335538
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140137.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Concord Nursing Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & 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.

NameRoleSinceShare
Deidre Pilgrim Individual Corporate OfficerBoard Member Jan 1, 2016 100%
Corporate DirectorBoard Member Jan 1, 2016
Samuel Phillips Individual Corporate OfficerChair Jan 1, 2016 100%
W-2 Managing EmployeeLnha Dec 1, 2022
Albert Wiltshire Individual Corporate OfficerBoard Member Jan 10, 2016 100%
Corporate DirectorBoard Member Jan 1, 2016
Erica Butler Individual Corporate OfficerSecretary Jan 1, 2016 100%
Craig Gaddy Individual Corporate OfficerBoard Member Jan 1, 2016 100%
Corporate DirectorBoard Member Jan 1, 2016

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1619004827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701104",
            "telephone_number": "718-931-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MADISON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112161509",
            "telephone_number": "718-636-7500",
            "fax_number": "718-636-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "NAT",
        "authorized_official_first_name": "EITAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-636-7500",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00314609",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concord Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.