NPIMap

Organization Active NPI

10400 Roosevelt Operating, LLC

Doing business as St. John Neumann Center for Rehabilitation & Healthcarer

  • Skilled Nursing Facility
  • Philadelphia, PA
National Provider Identifier
1659789949
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
10400 ROOSEVELT OPERATING, LLC
Doing business as
St. John Neumann Center for Rehabilitation & Healthcarer
Practice address
10400 Roosevelt Blvd
Philadelphia, PA 19116-3905
Phone
(610) 698-5619
NPI assigned
Jul 30, 2014
Last updated
Jul 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Authorized official

Name
Mr. Charles-Edouard Gros
Title
Manager
Phone
(718) 360-8083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10400 Roosevelt Blvd
Philadelphia, PA 19116-3905

Mailing address

701 Lansdale Ave
Lansdale, PA 19446-2958

Other names 1

  • St. John Neumann Center for Rehabilitation & Healthcarer Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141117000423 PA Part A Provider - Skilled Nursing Facility 9032331558 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659789949. Details of each certification follow.

Skilled nursing facility certification: CCN 395182

Legal name
10400 ROOSEVELT OPERATING LLC
Doing business as
ST. JOHN NEUMANN CENTER FOR REHABILITATION & HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 7, 1967
Last certification
Jan 24, 2025
Beds
226
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
May 7, 2014 in PA
Enrollment address
10400 Roosevelt Boulevard
Philadelphia, PA 19116-3905
Nursing home name
ST JOHN NEUMANN CTR FOR REHAB & HEALTHCARE
Affiliated entity
THE ROSENBERG FAMILY

Care Compare: Nursing home

Medicare Care Compare
Listed as
St John Neumann Ctr for Rehab & HealthcareCCN 395182 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 7, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
226217.6 residents per day on average
Chain
The Rosenberg Family16 facilities in the chain
Penalties (3 years)
1Fines totaling $26,043

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
39D0199554St John Neumann Center for Rehabilitation10400 Roosevelt Boulevard, Philadelphia, PA 19116Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
10400 Roosevelt Operating LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10400 Roosevelt Blvd
Philadelphia, PA 19116
Phone (215) 698-5600

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
10400 Roosevelt Realty Organization, Philadelphia, PA Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 28, 2023 100%
Adp of the SNF Nov 28, 2023
Avraham Rosenberg Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 10%
Moshe Basch Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 8.33%
Samuel Stern Individual Corporate OfficerCfo Jan 1, 2023
Adp of the SNF Nov 28, 2023
Moshe Rosenberg Individual 5% Or Greater Direct Ownership Interest Sep 1, 2014 26.65%
Yitzi Basch Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 8.33%
Zvi Rosenberg Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 10%
Annie Varughese Individual Operational/Managerial Control Apr 17, 2023
Adp of the SNF Nov 27, 1966
Joel Basch Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 8.33%
Larry W Spector Individual Operational/Managerial Control Jan 1, 2023
Adp of the SNF Mar 20, 2025
Esther Rosenberg Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 15.5%
Adp of the SNF Nov 28, 2023
Joshua Basch Individual 5% Or Greater Direct Ownership Interest Nov 28, 2023 8.33%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

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": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406678400000",
    "number": "1659789949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 LANSDALE AVE",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163905",
            "telephone_number": "610-698-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "10400 ROOSEVELT OPERATING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A",
        "authorized_official_last_name": "GROS",
        "authorized_official_first_name": "CHARLES-EDOUARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-360-8083",
        "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": "St. John Neumann Center for Rehabilitation & Healthcarer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.