Windsor Park Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WINDSOR PARK NURSING HOME, INC.

Practice address

21240 Hillside Ave
Queens Village, NY 11427-1816

Phone

(718) 468-0800

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Beena Varghese

Title

Administration

Phone

(718) 468-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639393168. Details of each certification follow.

• CCN 335155 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 335155

Legal name

WINDSOR PARK NURSING HOME, INC.

Doing business as

WINDSOR PARK NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 13, 1967

Last certification

Oct 3, 2024

Beds

70

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

May 1, 1986 in NY

Enrollment address

21240 Hillside Ave
Queens Village, NY 11427-1816

Nursing home name

WINDSOR PARK REHAB & NURSING CENTER

Listed as

Windsor Park Rehab & Nursing CenterCCN 335155 · All quality measures

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

5 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 13, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7061.5 residents per day on average

Penalties (3 years)

1Fines totaling $306,240

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 11

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

Practitioners 4

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.

• Arun Arora, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Flushing, NY
  • NPI 1154326825
  NPD (past)
• Rakesh K. Bhardwaj, M.D.

  • Pulmonary Disease Physician
  • Queens Village, NY
  • NPI 1265511877
  NPD (past)
• Arash Shifteh, D.O

  • Hospitalist Physician
  • New Hyde Park, NY
  • NPI 1154622421
  NPD (past)
• Kamyar D Tavakoli, M.D,

  • Internal Medicine Physician
  • Hollis, NY
  • NPI 1528148475
  NPD (past)

Affiliated clinicians 3

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

• Rakesh K. Bhardwaj, M.D.

  • Pulmonary Disease Physician
  • Queens Village, NY
  • NPI 1265511877

  Nursing home

  Care Compare affiliation
• Arash Shifteh, D.O

  • Hospitalist Physician
  • New Hyde Park, NY
  • NPI 1154622421

  Nursing home

  Care Compare affiliation
• Kamyar D Tavakoli, M.D,

  • Internal Medicine Physician
  • Hollis, NY
  • NPI 1528148475

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1639393168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21240 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21240 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271816",
            "telephone_number": "718-468-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR PARK NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "BEENA",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "718-468-0800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00930525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• White Glove
• Monica White-Williams, RN
• Vanessa Williams
• Claressa Fay Willis
• Bouvier Wilson, LPN
• Azra Wiqas, MD
• Chanelle Wofford, LPN
• Women on the Rise for God Ministries, Inc
• Michele Hong-Mun Wong, LMSW
• Philip Wong, RPH

• Skilled Nursing Facility in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.