NPIMap

Organization Active NPI

Nursing Care Center at Medford Inc

Doing business as Medford Multicare Center

  • Skilled Nursing Facility
  • Medford, NY
National Provider Identifier
1679563464
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5151319N Issued in NY
Legal business name
NURSING CARE CENTER AT MEDFORD INC
Doing business as
Medford Multicare Center
Practice address
3115 Horseblock Rd
Medford, NY 11763
Phone
(631) 730-3016
Fax
(631) 730-3131
NPI assigned
Oct 24, 2005
Last updated
Apr 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Authorized official

Name
Michael F Leahy
Title
Controller
Phone
(631) 730-3016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5151319N NY Primary

Addresses

Primary practice location

3115 Horseblock Rd
Medford, NY 11763

Mailing address

3115 Horseblock Rd
Medford, NY 11763
Phone (631) 730-3016

Other identifiers 1

IdentifierTypeStateIssuer
02357679MedicaidNY

Other names 1

  • Medford Multicare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031016000019 NY Part A Provider - Skilled Nursing Facility 9537071311 Practice locations: Medford, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679563464. Details of each certification follow.

Skilled nursing facility certification: CCN 335840

Legal name
NURSING CARE CENTER AT MEDFORD INC
Doing business as
MEDFORD MULTICARE CENTER FOR LIVING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2002
Last certification
Feb 28, 2025
Beds
320
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
May 20, 1998 in NY
Enrollment address
3115 Horseblock Rd
Medford, NY 11763-2526
Nursing home name
MEDFORD MULTICARE CENTER FOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Medford Multicare Center For LivingCCN 335840 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
320293.9 residents per day on average
Penalties (3 years)
1Fines totaling $134,713

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
33D2004608Medford Multicare Center for the Living3115 Horseblock Rd, Medford, NY 11763Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Neeru Kumar Individual Operational/Managerial Control Dec 19, 2023
Adp of the SNF Dec 19, 2023
Lauren Braska Individual Operational/Managerial Control Jul 1, 2022
Adp of the SNF Feb 12, 2025
Norman S Rausman Individual Corporate OfficerBoard Member Jan 1, 2002
Corporate Director Jan 1, 2002
Direct Ownership Interest Jan 1, 2002 49.5%
Mordechai Klein Individual 5% Or Greater Direct Ownership InterestPresident Jan 1, 2002 50%
Martin Loeb Individual General Partnership Interest May 19, 2019 0.5%
Individual Trustee of the SNF Aug 1, 2024
Adp of the SNF Aug 1, 2024

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 9

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 6

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": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1679563464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 HORSEBLOCK RD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "631-730-3016",
            "fax_number": "631-730-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 HORSEBLOCK RD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "631-730-3016",
            "fax_number": "631-730-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSING CARE CENTER AT MEDFORD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "LEAHY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "631-730-3016"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5151319N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02357679",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medford Multicare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.