Active NPI
The Bay at Sheridan Health and Rehabilitation LLC
- Skilled Nursing Facility
- Kenosha, WI
National Provider Identifier
1629504352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- THE BAY AT SHERIDAN HEALTH AND REHABILITATION LLC
- Practice address
- 8400 Sheridan Rd
Kenosha, WI 53143 - Phone
- (262) 658-4141
- NPI assigned
- May 1, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Menachem Ruvel
- Title
- Manager
- Phone
- (516) 605-9800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
8400 Sheridan Rd
Kenosha, WI 53143
Mailing address
8400 Sheridan Rd
Kenosha, WI 53143-6327
Phone (262) 658-4141
Other names 1
- Sheridan Health and Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180329001068 | WI | Part A Provider - Skilled Nursing Facility | 3072875111 | Practice locations: Kenosha, WI |
Skilled nursing facility certification: CCN 525318
- Legal name
- THE BAY AT SHERIDAN HEALTH AND REHABILITATION LLC
- Doing business as
- SHERIDAN HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1982
- Last certification
- Aug 22, 2024
- Beds
- 81
- Ownership / control type
- Corporation
- Multi-facility organization
- CHAMPION HEALTH CARE
- Organization structure
- LLC
- Incorporated
- Jul 1, 2017 in WI
- Enrollment address
- 8400 Sheridan Rd
Kenosha, WI 53143-6327 - Nursing home name
- SHERIDAN HEALTH AND REHABILITATION CENTER
- Affiliated entity
- CHAMPION CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sheridan Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1982
- Medicare certification status
- Active
- Certified beds
- 81
- Chain
- Champion Care
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0671561 | Sheridan Health and Rehabilitation | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| The Bay at Sheridan Health and Rehabilitation LLC | Operational/Managerial Control | Feb 1, 2018 | 100% |
| Menachem Ruvel | 5% Or Greater Direct Ownership Interest | Feb 1, 2018 | 50% |
| Corporate Director | Feb 1, 2018 | 50% | |
| Operational/Managerial Control | Feb 1, 2018 | 50% | |
| Yisroel N Weinberg | 5% Or Greater Direct Ownership Interest | Jul 1, 2017 | 50% |
| Corporate Director | Feb 1, 2018 | 50% | |
| Operational/Managerial Control | Feb 1, 2018 | 50% |
Practitioners & affiliated clinicians
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": "1493596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694131200000",
"number": "1629504352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8400 SHERIDAN RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531436327",
"telephone_number": "262-658-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8400 SHERIDAN RD",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53143",
"telephone_number": "262-658-4141"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE BAY AT SHERIDAN HEALTH AND REHABILITATION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-01",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A",
"authorized_official_last_name": "RUVEL",
"authorized_official_first_name": "MENACHEM",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "516-605-9800"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sheridan Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.