NPIMap

Organization Active NPI

Fieldston Lodge Care Center

  • Skilled Nursing Facility
  • Bronx, NY
National Provider Identifier
1679797625
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7000385N Issued in NY
Legal business name
FIELDSTON LODGE CARE CENTER
Practice address
666 Kappock St
Bronx, NY 10463-7704
Phone
(917) 549-1203
Fax
(718) 884-3792
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Authorized official

Name
Mr. Jonathan Gewirtz
Title
Manager, Fiscal Oversight
Phone
(914) 588-8379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7000385N NY Primary

Addresses

Primary practice location

666 Kappock St
Bronx, NY 10463-7704

Mailing address

666 Kappock St
Bronx, NY 10463-7704
Phone (917) 549-1203

Other identifiers 1

IdentifierTypeStateIssuer
00310605MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120110000484 NY Part A Provider - Skilled Nursing Facility 5597674473 Practice locations: Bronx, NY

Skilled nursing facility certification: CCN 335248

Legal name
FIELDSTON LODGE CARE CENTER
Doing business as
FIELDSTON LODGE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 3, 1968
Last certification
Apr 2, 2024
Beds
200 (190 certified)
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
666 Kappock St
Bronx, NY 10463-7704
Nursing home name
INDEPENDENCE CARE CENTER FOR NURSING AND REHABILITATION
Affiliated entity
THE MAYER FAMILY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Independence Care Center for Nursing and RehabilitCCN 335248 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 3, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
190168.7 residents per day on average
Chain
The Mayer Family11 facilities in the chain
Penalties (3 years)
1Fines totaling $66,859

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
33D0653548Fieldston Lodge Care Center666 Kappock Street, Bronx, NY 10463Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Yosef Ruben Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 11.15%
Jonathan Gewirtz Individual W-2 Managing EmployeeController Oct 1, 2011
Nachum Davidowitch Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 23.5%
Sam Eisikowicz Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 14.65%
Giorgio Mayer Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 12.35%
David Landa Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 26%
Andrea Mayer Individual 5% Or Greater Direct Ownership Interest Sep 1, 2003 12.35%

Practitioners & affiliated clinicians

Practitioners 4

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

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1679797625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "666 KAPPOCK ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104637704",
            "telephone_number": "917-549-1203",
            "fax_number": "718-884-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 KAPPOCK ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104637704",
            "telephone_number": "917-549-1203",
            "fax_number": "718-884-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIELDSTON LODGE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "GEWIRTZ",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGER, FISCAL OVERSIGHT",
        "authorized_official_telephone_number": "914-588-8379",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7000385N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.