NPIMap

Organization Active NPI

Port Charlotte Care Center LLC

  • Skilled Nursing Facility
  • Port Charlotte, FL
National Provider Identifier
1619603248
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PORT CHARLOTTE CARE CENTER LLC
Doing business as
Charlotte Bay rehab and care center
Port Charlotte Care Center
Practice address
4033 Beaver LN
Port Charlotte, FL 33952-9206
Phone
(941) 624-2358
NPI assigned
Jul 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Joel Leifer
Title
Ceo
Phone
(718) 705-6740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4033 Beaver LN
Port Charlotte, FL 33952-9206

Mailing address

4033 Beaver LN
Port Charlotte, FL 33952-9206

Other identifiers 1

IdentifierTypeStateIssuer
14510962OtherFLLICENSE

Other names 2

  • Charlotte Bay rehab and care center Doing business as
  • Port Charlotte Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL shcofportcharlotte.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221123000252 FL Part A Provider - Skilled Nursing Facility 5890163885 Practice locations: Port Charlotte, FL

Skilled nursing facility certification: CCN 105363

Legal name
PORT CHARLOTTE CARE CENTER LLC
Doing business as
CHARLOTTE BAY REHAB AND CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 11, 1980
Last certification
Jan 30, 2025
Beds
164
Ownership / control type
Corporation
Multi-facility organization
Excelsior Care Group
Most recent change of ownership
Nov 1, 2022
Organization structure
LLCProprietary
Incorporated
Jul 7, 2022 in FL
Enrollment address
4033 Beaver LN
Port Charlotte, FL 33952-9206
Nursing home name
CHARLOTTE BAY REHAB AND CARE CENTER
Affiliated entity
EXCELSIOR CARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Charlotte Bay Rehab and Care CenterCCN 105363 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 11, 1980
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
164155.3 residents per day on average
Chain
Excelsior Care Group33 facilities in the chain
Penalties (3 years)
2Fines totaling $274,053

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
10D1081129Charlotte Bay Rehab and Care Center4033 Beaver Lane, Port Charlotte, FL 33952Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Cheskel David Berkowitz Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 30%
Joel Zupnick Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 30%
Benjamin Landa Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%
Port Charlotte Care Member LLC Organization, Port Charlotte, FL Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 7, 2022 100%
Joel Leifer Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 30%
Corporate Officer Oct 8, 2022 100%
Erin Soltis Individual W-2 Managing EmployeeAdministrator Nov 1, 2022 100%
Flnho Capital Group LLC Organization, Mineola, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10%

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1658793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1619603248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 BEAVER LN",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 BEAVER LN",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529206",
            "telephone_number": "941-624-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CHARLOTTE CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "LEIFER",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-705-6740"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "14510962",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "shcofportcharlotte.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4033 Beaver Ln",
            "city": "Port Charlotte",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339529206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Charlotte Bay rehab and care center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Charlotte Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.