Organization Active NPI

Vantage at Lowell LLC

  • Skilled Nursing Facility
  • Lowell, MA
National Provider Identifier
1639055460
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
VANTAGE AT LOWELL LLC
Practice address
500 Wentworth Ave
Lowell, MA 01852-4937
Phone
(978) 458-1271
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Sam Yurowitz
Title
Authorized Official
Phone
(845) 558-2685

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

500 Wentworth Ave
Lowell, MA 01852-4937

Mailing address

500 Wentworth Ave
Lowell, MA 01852-4937
Phone (978) 458-1271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218003712 MA Part A Provider - Skilled Nursing Facility 9537649421 Practice locations: Lowell, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639055460. Details of each certification follow.

Skilled nursing facility certification: CCN 225489

Legal name
VANTAGE AT LOWELL LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1990
Last certification
May 16, 2024
Beds
115
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Vantage Health Care
Organization structure
LLCProprietary
Enrollment address
500 Wentworth Ave
Lowell, MA 01852-4937
Nursing home name
VANTAGE AT LOWELL LLC
Affiliated entity
VANTAGE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vantage at Lowell LLCCCN 225489 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Jul 1, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11579.8 residents per day on average
Chain
Vantage Care10 facilities in the chain
Penalties (3 years)
1Fines totaling $13,497
Ownership change
Changed ownership in the last 12 months

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
22D0869613Vantage Health and Rehab of Lowell500 Wentworth Avenue, Lowell, MA 01852Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Miriam Tehilah Herskovitz Individual 5% Or Greater Direct Ownership Interest Dec 29, 2025 25%
Jeri Ann Johnson Individual Operational/Managerial Control Dec 29, 2025
Managing Control - Governing Body Dec 29, 2025
Adp of the SNF Dec 29, 2025
Organization, Lawrence, NY Adp of the SNF Dec 29, 2025
Organization, Brooklyn, NY Adp of the SNF Dec 29, 2025
Organization, Brooklyn, NY LLC, Holding company Adp of the SNF Dec 29, 2025
LTC Consulting Services LLC Organization, Lakewood, NJ LLC Adp of the SNF Dec 29, 2025
Innovations Healthcare, LLC Organization, Pascoag, RI LLC Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 11, 2025
Louis Bresnick Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Cheryl Arem Individual 5% Or Greater Direct Ownership Interest Dec 29, 2025 25%
Im Family Holdings LLC Organization, Brooklyn, NY LLC Adp of the SNF Dec 29, 2025
Organization, Lowell, MA LLC Adp of the SNF Dec 29, 2025
Vantage Lowell Realty LLC Organization, Lowell, MA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Dec 29, 2025 100%
Adp of the SNF Dec 29, 2025
Ryan Gaughan Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Jca Capital Associates LLC Organization, Brooklyn, NY LLC Adp of the SNF Dec 29, 2025
Morris Green Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Apr 8, 2024
Donna Cahill Individual Operational/Managerial Control Dec 29, 2025
Adp of the SNF Dec 29, 2025
Organization, Lawrence, NY Adp of the SNF Dec 29, 2025
Sam Yurowitz Individual 5% Or Greater Direct Ownership InterestPrincipal Owner Dec 29, 2025 25%
Corporate OfficerPrincipal Owner Dec 29, 2025
Corporate DirectorPrincipal Owner Dec 29, 2025
Operational/Managerial Control Dec 29, 2025
Managing Control - Governing Body Dec 15, 2025
Adp of the SNF Dec 15, 2025
Organization, Brooklyn, NY Adp of the SNF Dec 29, 2025
Yossi Brown Individual 5% Or Greater Direct Ownership InterestPrincipal Owner Dec 29, 2025 25%
Corporate OfficerPrincipal Owner Dec 29, 2025
Corporate DirectorPrincipal Owner Dec 29, 2025
Operational/Managerial Control Dec 29, 2025
Managing Control - Governing Body Dec 29, 2025
Adp of the SNF Dec 29, 2025
Vantage Care Ma4 LLC Organization, Brooklyn, NY LLC Adp of the SNF Dec 29, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1639055460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WENTWORTH AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524937",
            "telephone_number": "978-458-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WENTWORTH AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018524937",
            "telephone_number": "978-458-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE AT LOWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "YUROWITZ",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-558-2685"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.