NPIMap

Organization Active NPI

San Rafael Operating Company LP

  • Skilled Nursing Facility
  • San Rafael, CA
National Provider Identifier
1659610814
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SAN RAFAEL OPERATING COMPANY LP
Practice address
45 Professional Center Pkwy
San Rafael, CA 94903-2702
Phone
(415) 479-3610
NPI assigned
Feb 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Mrs. Andrea Saavedra
Title
Regional Financial Analyst
Phone
(707) 208-1940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

45 Professional Center Pkwy
San Rafael, CA 94903-2702

Mailing address

45 Professional Center Pkwy
San Rafael, CA 94903-2702
Phone (415) 479-3610

Other identifiers 1

IdentifierTypeStateIssuer
ZZR05850MMedicaidCA

Other names 1

  • Pine Ridge Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131112001077 CA Part A Provider - Skilled Nursing Facility 0345333761 Practice locations: San Rafael, CA

Skilled nursing facility certification: CCN 055850

Legal name
SAN RAFAEL OPERATING COMPANY LP
Doing business as
PINE RIDGE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1967
Last certification
Dec 12, 2024
Beds
101
Ownership / control type
Partnership
Organization structure
PartnershipProprietary
Enrollment address
45 Professional Center Pkwy
San Rafael, CA 94903-2702
Nursing home name
PINE RIDGE CARE CENTER
Affiliated entity
MARINER HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pine Ridge Care CenterCCN 055850
Overall star rating
5 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Nov 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10186.5 residents per day on average
Chain
Mariner Health Care17 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0896255Pine Ridge Care Center45 Professional Center Parkway, San Rafael, CA 94903Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Grancare LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2005 100%
Capital Funding Group, LLC Organization, Baltimore, MD Corporation, Financial institution 5% Or Greater Security Interest Nov 1, 2021 100%
GC Holding Company 3, LLC Organization, Atlanta, GA LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Aug 1, 2022 99%
Limited Partnership Interest Aug 1, 2022 99%
MHC West Holding Company Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2005 100%
National Senior Care, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2005 100%
Noel Serrano Individual Operational/Managerial Control Dec 1, 2021
Adp of the SNF Dec 1, 2021
Michael Monroe Individual Operational/Managerial Control May 24, 2022
Managing Control - Governing BodyAdministrator May 24, 2022
Adp of the SNF May 24, 2022
MHC Holding Company Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2005 100%
Mariner Health Care, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2015 100%
San Rafael Operating Company GP, LLC Organization, Atlanta, GA LLC, Holding company, For-profit General Partnership Interest Dec 21, 2005 1%
Emily Grunstein Individual 5% Or Greater Indirect Ownership Interest Feb 6, 2019 100%
Dennis Sarcauga Individual Operational/Managerial Control Feb 6, 2025
Managing Control - Governing BodyPresident Feb 6, 2025
Adp of the SNF Feb 6, 2025
Adan Melijoy Individual Operational/Managerial Control Aug 27, 2012
Managing Control - Governing BodyDirector of Nursing Aug 27, 2012
Adp of the SNF Aug 27, 2012

Owners & managing parties with NPI records 1

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

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1659610814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PROFESSIONAL CENTER PKWY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032702",
            "telephone_number": "415-479-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PROFESSIONAL CENTER PKWY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032702",
            "telephone_number": "415-479-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN RAFAEL OPERATING COMPANY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "SAAVEDRA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "REGIONAL FINANCIAL ANALYST",
        "authorized_official_telephone_number": "707-208-1940",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05850M",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Ridge Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.