Organization Active NPI

Buckingham at Norwood Care and Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Norwood, NJ
National Provider Identifier
1629074059
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
053334 Issued in NJ
Legal business name
BUCKINGHAM AT NORWOOD CARE AND REHABILITATION CENTER LLC
Practice address
100 McClellen St
Norwood, NJ 07648-1555
Phone
(201) 768-6222
Fax
(201) 767-8354
NPI assigned
Jun 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Mrs. Deborah Condorelli
Title
VP Finance & Census Development
Phone
(201) 767-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 053334 NJ Primary

Addresses

Primary practice location

100 McClellen St
Norwood, NJ 07648-1555

Mailing address

100 McClellen St
Norwood, NJ 07648-1555
Phone (201) 767-0100

Other identifiers 1

IdentifierTypeStateIssuer
8878005MedicaidNJ

Other names 1

  • Heritage at Norwood Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070924000362 NJ Part A Provider - Skilled Nursing Facility 5597859314 Practice locations: Norwood, NJ

Skilled nursing facility certification: CCN 315290

Legal name
BUCKINGHAM AT NORWOOD CARE AND REHABILITATION CENTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 16, 1990
Last certification
Nov 7, 2024
Beds
240
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jan 18, 2002 in NJ
Enrollment address
100 McClellen St
Norwood, NJ 07648-1555
Nursing home name
BUCKINGHAM AT NORWOOD, THE
Affiliated entity
EXCELCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Buckingham at Norwood, theCCN 315290
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 16, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
240179.5 residents per day on average
Chain
Excelcare8 facilities in the chain
Penalties (3 years)
1Fines totaling $76,226

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Trevor Dublin Individual W-2 Managing EmployeeAdministrator Dec 3, 2018 100%
Livia Jacobs Individual 5% Or Greater Direct Ownership Interest Jan 18, 2002 5%
Hyman Jacobs Individual 5% Or Greater Direct Ownership Interest Jan 18, 2002 95%
Christopher J Metternich Individual Corporate OfficerChief Operating Officer Aug 17, 2017

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1629074059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCCLELLEN ST",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481555",
            "telephone_number": "201-767-0100",
            "fax_number": "201-881-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCCLELLEN ST",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481555",
            "telephone_number": "201-768-6222",
            "fax_number": "201-767-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKINGHAM AT NORWOOD CARE AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "CONDORELLI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VP FINANCE & CENSUS DEVELOPMENT",
        "authorized_official_telephone_number": "201-767-0100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "053334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8878005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage at Norwood",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Norwood, NJ

Sources for this page

Verify at the official NPI Registry.