SH Ithaca Operator, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SH ITHACA OPERATOR, INC.

Practice address

103 Bundy Rd
Ithaca, NY 14850-9252

Phone

(607) 256-2580

NPI assigned

Mar 17, 2025

Organization subpart

No

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

Authorized official

Name

Anna F.C. Munoz

Title

Assistant Secretary

Phone

(414) 918-5443

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Ithaca Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1649070731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BUNDY RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509252",
            "telephone_number": "607-256-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 BUNDY RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148509252",
            "telephone_number": "607-256-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH ITHACA OPERATOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Ithaca Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jillian Senner, D.O.
• Serenity Care Facilities LLC
• Nicole Ann Serrano, FNP
• Lois J Sessions, COTA
• Louise Anne Seyge, REGISTERED NURSE
• Jill Shah, PT, DPT
• Sapan Shah, M.D.
• Syed Jibran Shah, D.O
• Mohammad Ali Shahab, MBBS
• Hamid Saeed Shaikh

• Assisted Living Facility in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.