Sheboygan SNF Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHEBOYGAN SNF OPERATIONS LLC

Practice address

3014 Erie Ave
Sheboygan, WI 53081-3658

Phone

(920) 459-3028

NPI assigned

Dec 5, 2024

Last updated

Dec 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maxim Stesel

Title

Manager

Phone

(773) 825-3336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669288650. Details of each certification follow.

• CCN 525568 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525568

Legal name

SHEBOYGAN SNF OPERATIONS, LLC

Doing business as

EDENBROOK SHEBOYGAN

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1995

Last certification

Feb 28, 2024

Beds

121

Ownership / control type

Corporation

Multi-facility organization

Eden Senior Care

Most recent change of ownership

Apr 24, 2025

Organization structure

LLCProprietary

Enrollment address

3014 Erie Ave
Sheboygan, WI 53081-3658

Nursing home name

EDENBROOK SHEBOYGAN

Affiliated entity

EDEN SENIOR CARE

Listed as

Edenbrook SheboyganCCN 525568 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12160.6 residents per day on average

Chain

Eden Senior Care21 facilities in the chain

Penalties (3 years)

4Fines totaling $345,576

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 15

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.

• Sandeep R Ramanujam, M.D.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1770756678

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• Great Lakes Home Health LLC

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1346816501

  Eden Senior Care LLC

  CMS ownership

Practitioners 1

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.

• Sandeep R Ramanujam, M.D.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1770756678
  NPD (past)

Affiliated clinicians 2

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

• Bora You

  • Family Medicine Physician
  • Sheboygan, WI
  • NPI 1134579493

  Nursing home

  Care Compare affiliation
• Elizabeth Lynn Zurich, DO

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1396902219

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1669288650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762914",
            "telephone_number": "773-825-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-459-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEBOYGAN SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-825-3336"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheboygan Pediatric Associates SC
• Sheboygan Physicians Group, SC
• Sheboygan Regional Oncology Center, LTD.
• Sheboygan Senior Community, Inc.
• Sheboygan Senior Living, Inc. (The Shores of Sheboygan Assisted Living I)
• Sheboygan Surgical Associates, S.C.
• Sheboygan Urology Specialists, S.C.
• Sheboygan Women's Health, S.C.
• Sheboyganctd LLC
• Carol Sherman Haid, MA, LCPC, BCPC

• Skilled Nursing Facility in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.