San Jose Blvd Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SAN JOSE BLVD OPCO LLC

Doing business as

Aviata at San Jose

Practice address

9355 San Jose Blvd
Jacksonville, FL 32257-5503

Phone

(904) 739-0877

Fax

(904) 448-9253

NPI assigned

Jul 14, 2023

Organization subpart

No

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

Authorized official

Name

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at San Jose Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Skilled nursing facility certification: CCN 105531

Legal name

SAN JOSE BLVD OPCO LLC

Doing business as

AVIATA AT SAN JOSE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 20, 1985

Last certification

Apr 24, 2025

Beds

120

Ownership / control type

Corporation

Multi-facility organization

Aspire Health Group

Most recent change of ownership

Sep 1, 2023

Organization structure

LLCProprietary

Incorporated

Jul 5, 2023 in FL

Enrollment address

9355 San Jose Blvd
Jacksonville, FL 32257-5503

Nursing home name

AVIATA AT SAN JOSE

Affiliated entity

AVIATA HEALTH GROUP

Listed as

Aviata at San JoseCCN 105531 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Dec 20, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120112.0 residents per day on average

Chain

Aviata Health Group50 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 10

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

Owners & managing parties with NPI records 1

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

• George Yazji, MD

  • Hospitalist Physician
  • Gainesville, FL
  • NPI 1417417924

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• George Yazji, MD

  • Hospitalist Physician
  • Gainesville, FL
  • NPI 1417417924

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1659050722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9355 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575503",
            "telephone_number": "904-739-0877",
            "fax_number": "904-448-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9355 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575503",
            "telephone_number": "904-739-0877",
            "fax_number": "904-448-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE BLVD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at San Jose",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harricia Samuels
• Kaaliyah Samuels
• Sonya N Samuels, L.M.T.
• Hazem Mahmoud Samy, MD
• San Jose Aspen PLLC
• San Jose Chiropractic, LLC
• San Jose Clinic, P.a.
• San Jose Family Denistry
• San Jose Imaging Center LLC
• San Jose Therapy Services LLC

• Skilled Nursing Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.