Active NPI
Atba, LLC
Doing business as North Park Post-Acute
- Skilled Nursing Facility
- Tracy, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ATBA, LLC
- Doing business as
- North Park Post-Acute
- Practice address
- 2586 Buthmann Ave
Tracy, CA 95376-2165 - Phone
- (209) 832-2273
- NPI assigned
- Dec 7, 2020
- Last updated
- Dec 7, 2020
- 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
- Mr. Jeffrey Bradshaw
- Title
- Manager
- Phone
- (949) 347-7100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
2586 Buthmann Ave
Tracy, CA 95376-2165
Mailing address
28202 Cabot Rd Ste 412
Laguna Niguel, CA 92677-1271
Phone (949) 370-7130
Other names 1
- North Park Post-Acute
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210204002546 | CA | Part A Provider - Skilled Nursing Facility | 7911311808 | Practice locations: Tracy, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1649876541. Details of each certification follow.
Skilled nursing facility certification: CCN 555245
- Legal name
- ATBA, LLC
- Doing business as
- NORTH PARK POST-ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 25, 1987
- Last certification
- Oct 4, 2024
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 2586 Buthmann Ave
Tracy, CA 95376-2165 - Nursing home name
- NORTH PARK POST-ACUTE
- Affiliated entity
- ASPEN SKILLED HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- North Park Post-Acute
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 25, 1987
- Medicare certification status
- Active
- Certified beds
- 99
- Chain
- Aspen Skilled Healthcare
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 |
|---|---|---|---|
| 05D0644045 | North Park Post-Acute | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 22
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 |
|---|---|---|---|
| Craig Orgill | Indirect Ownership Interest | Nov 3, 2021 | 1.3% |
| Jared Kirkwood | Indirect Ownership Interest | Nov 3, 2021 | 0.3% |
| Colton Rawe | Operational/Managerial Control | Jan 1, 2023 | |
| Managing Control - Governing Body | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Eric Elsner | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
| Jeffrey J Bradshaw | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Nov 3, 2021 | 22.25% | |
| Tanner Howard | Operational/Managerial Control | Oct 3, 2022 | |
| Adp of the SNF | Oct 3, 2022 | ||
| Sequoia Healthcare Group LLC | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Jan 1, 2023 | 100% | |
| Ryan M Case | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Nov 3, 2021 | 31.77% | |
| Marcus J Paxman | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Apr 1, 2022 | 0.01% | |
| Pranjalkumar H Patel | Operational/Managerial Control | Jan 1, 2021 | |
| Adp of the SNF | Jan 1, 2021 | ||
| Aspen Healthcare Services LLC | Adp of the SNF | Jan 1, 2023 | |
| Wells Fargo Bank, National Association | Adp of the SNF | Nov 3, 2021 | |
| Adp of the SNF | Sep 22, 2025 | ||
| East West Bank | Adp of the SNF | Nov 3, 2021 | |
| Frank Jurado | Adp of the SNF | Jan 1, 2023 | |
| Vern J Brady | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Nov 3, 2021 | 31.95% | |
| Atba, LLC | Operational/Managerial Control | Nov 3, 2021 | |
| Adp of the SNF | Nov 3, 2021 | ||
| Direct Ownership Interest | Nov 3, 2021 | 100% | |
| Desiree Concha | Operational/Managerial Control | Aug 23, 2021 | |
| Adp of the SNF | Aug 23, 2021 | ||
| Shruty Parti | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
| Moss Adams LLP | Adp of the SNF | Nov 3, 2021 | |
| Peter Bradshaw | Indirect Ownership Interest | Jul 7, 2023 | 0.09% |
| Rajesh Parti | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Tracy, CA
- NPI 1225233133
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
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": "1607299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607299200000",
"number": "1649876541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28202 CABOT RD STE 412",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926771271",
"telephone_number": "949-370-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2586 BUTHMANN AVE",
"city": "TRACY",
"state": "CA",
"postal_code": "953762165",
"telephone_number": "209-832-2273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATBA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A",
"authorized_official_last_name": "BRADSHAW",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "949-347-7100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "North Park Post-Acute",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.