Williamsport North SNF Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WILLIAMSPORT NORTH SNF OPERATIONS LLC

Practice address

300 Leader Dr
Williamsport, PA 17701-1943

Phone

(773) 825-3336

NPI assigned

Aug 28, 2024

Organization subpart

No

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

Authorized official

Name

Max Stesel

Title

Manager

Phone

(773) 825-3336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Skilled nursing facility certification: CCN 395364

Legal name

WILLIAMSPORT NORTH SNF OPERATIONS, LLC

Doing business as

EDENBROOK NORTH

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1977

Last certification

Apr 4, 2025

Beds

152

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Eden Senior Care

Organization structure

LLC

Enrollment address

300 Leader Dr
Williamsport, PA 17701-1943

Nursing home name

EDENBROOK NORTH

Affiliated entity

EDEN SENIOR CARE

Listed as

Edenbrook NorthCCN 395364

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

152104.7 residents per day on average

Chain

Eden Senior Care21 facilities in the chain

Penalties (3 years)

1Fines totaling $305,250

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 10

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Andrew Eric Graf

  • Internal Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1316108269

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

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

• Andrew Eric Graf

  • Internal Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1316108269
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Cecile S. Muehrcke, M.D.

  • Internal Medicine Physician
  • Marathon, FL
  • NPI 1053353318

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1629802111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-825-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LEADER DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011943",
            "telephone_number": "773-825-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSPORT NORTH SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-825-3336"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Williamsport Area School District
• Williamsport Dental & Dentures, Inc
• Williamsport Family Medical Center, LLC
• Williamsport Home
• Williamsport North Operations LLC
• Williamsport Obstetrics & Gynecology, P.C.
• Williamsport Orthopedic & Prosthetic Company Inc
• Williamsport Pathology Assocs.
• Williamsport Physical Medicine, Inc.
• Williamsport Physical Medicine, Inc.

• All providers in Williamsport, PA
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.

Verify at the official NPI Registry.