Active NPI
Chestnut Ridge Post Acute LLC
- Skilled Nursing Facility
- Glendale, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CHESTNUT RIDGE POST ACUTE LLC
- Practice address
- 525 S Central Ave
Glendale, CA 91204-2006 - Phone
- (818) 240-1610
- Fax
- (818) 845-1169
- NPI assigned
- Mar 26, 2021
- Last updated
- Mar 26, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phillip L Chase
- Title
- Manager
- Phone
- (818) 240-1610
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
525 S Central Ave
Glendale, CA 91204-2006
Mailing address
8484 Wilshire Blvd Ste 215
Beverly Hills, CA 90211-3245
Phone (818) 240-1610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT06190F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220422002454 | CA | Part A Provider - Skilled Nursing Facility | 3476940370 | Practice locations: Glendale, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1649857301. Details of each certification follow.
Skilled nursing facility certification: CCN 056190
- Legal name
- CHESTNUT RIDGE POST ACUTE LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 11, 1970
- Last certification
- Oct 4, 2024
- Beds
- 106
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 525 S Central Ave
Glendale, CA 91204-2006 - Nursing home name
- CHESTNUT RIDGE POST ACUTE LLC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Chestnut Ridge Post Acute LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 11, 1970
- Medicare certification status
- Active
- Certified beds
- 106
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 3
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 |
|---|---|---|---|
| 05D0556797 | Chestnut Ridge Post Acute LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
8484 Wilshire Blvd
Ste 215
Beverly Hills, CA 90211
Ownership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Juhn Cayabyab | Operational/Managerial Control | Feb 1, 2022 | |
| Managing Control - Governing Body | Feb 1, 2022 | ||
| Adp of the SNF | Feb 1, 2022 | ||
| Lorna del Rosario | Operational/Managerial Control | Sep 24, 2021 | |
| Adp of the SNF | Sep 24, 2021 | ||
| Hayk V Papukhyan | Operational/Managerial Control | Jun 1, 2025 | |
| Adp of the SNF | Jun 1, 2025 | ||
| Phillip L Chase | Operational/Managerial Control | Jan 30, 2024 | |
| Managing Control - Governing Body | Jan 30, 2024 | ||
| Adp of the SNF | Jan 30, 2024 | ||
| Glendale Investment Group LLC | 5% Or Greater Mortgage Interest | Dec 1, 2022 | 100% |
| Adp of the SNF | Jun 12, 1981 | ||
| The Phillip Chase Irrevocable Trust | 5% Or Greater Direct Ownership Interest | Jan 30, 2024 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Los Angeles, CA
- NPI 1992200315
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Inland Valley Care & Rehab Center
- Skilled Nursing Facility
- Pomona, CA
- NPI 1841232279
The Phillip Chase Irrevocable Trust
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1616716800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616716800000",
"number": "1649857301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8484 WILSHIRE BLVD STE 215",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902113245",
"telephone_number": "818-240-1610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 S CENTRAL AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912042006",
"telephone_number": "818-240-1610",
"fax_number": "818-845-1169"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHESTNUT RIDGE POST ACUTE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-26",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A",
"authorized_official_last_name": "CHASE",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "818-240-1610"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT06190F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.