Active NPI
Sail Nursing and Rehabilitation Center, LLC
- Skilled Nursing Facility
- Jacksonville, FL
National Provider Identifier
1629574884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SAIL NURSING AND REHABILITATION CENTER, LLC
- Practice address
- 730 College St
Jacksonville, FL 32204-3313 - Phone
- (914) 548-7617
- Fax
- (914) 633-1620
- NPI assigned
- Apr 4, 2018
- Last updated
- Apr 17, 2018
- Organization subpart
- Yes
- Parent organization
- SAIL HEALTHCARE HOLDINGS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven Bicky
- Title
- Manager
- Phone
- (914) 548-7617
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
730 College St
Jacksonville, FL 32204-3313
Mailing address
4770 Biscayne Blvd Ste 1400
Miami, FL 33137-3243
Phone (786) 245-2317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180706000651 | FL | Part A Provider - Skilled Nursing Facility | 2567718406 | Practice locations: Jacksonville, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1629574884. Details of each certification follow.
Skilled nursing facility certification: CCN 105813
- Legal name
- SAIL NURSING AND REHABILITATION CENTER, LLC
- Doing business as
- PARK RIDGE NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1993
- Last certification
- May 16, 2024
- Beds
- 104
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Mar 28, 2018 in FL
- Enrollment address
- 730 College St
Jacksonville, FL 32204-3313 - Nursing home name
- PARK RIDGE NURSING CENTER
- Affiliated entity
- MAXIMUS HEALTHCARE GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Park Ridge Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1993
- Medicare certification status
- Active
- Certified beds
- 104
- Chain
- Maximus Healthcare Group
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 |
|---|---|---|---|
| 10D0989854 | Sail Nursing and Rehabilitation | Certificate of waiver | Aug 7, 2027 |
National Provider Directory
National Provider Directory- Part of
- Sail Healthcare Holdings LLC
Locations
4700 Biscayne Blvd
Ste 1400
Miami, FL 33137
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| Sail Healthcare Holding, LLC | 5% Or Greater Direct Ownership Interest | Mar 28, 2018 | 100% |
| Regal Healthcaremanagement, LLC | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 40% |
| NKW Properties, LTD | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 20% |
| SRG Business Trust-Sarit Galbut Trustee | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 6.6% |
| JG Business Trust-Jillian Galbut Trustee | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 6.6% |
| Yisroel Bornstein | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 20% |
| NKW Business Trust-Nancy Galbut Trustee | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 6.6% |
| Jeffrey H Tomack | W-2 Managing Employee | Jul 1, 2018 | 100% |
| Steven Bicky | 5% Or Greater Indirect Ownership Interest | Mar 28, 2018 | 40% |
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Skilled Nursing Facility
- Jacksonville, FL
- NPI 1285130443
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Jacksonville, FL
- NPI 1942494984
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1523923200000",
"number": "1629574884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4770 BISCAYNE BLVD STE 1400",
"city": "MIAMI",
"state": "FL",
"postal_code": "331373243",
"telephone_number": "786-245-2317",
"fax_number": "305-573-6362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 COLLEGE ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322043313",
"telephone_number": "914-548-7617",
"fax_number": "914-633-1620"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAIL NURSING AND REHABILITATION CENTER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SAIL HEALTHCARE HOLDINGS, LLC",
"enumeration_date": "2018-04-04",
"last_updated": "2018-04-17",
"status": "A",
"authorized_official_last_name": "BICKY",
"authorized_official_first_name": "STEVEN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "914-548-7617"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.