NPIMap

Organization Active NPI

Edgewood Rehab and Healthcare Center LLC

  • Skilled Nursing Facility
  • Portsmouth, NH
National Provider Identifier
1689309304
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EDGEWOOD REHAB AND HEALTHCARE CENTER LLC
Practice address
928 South St
Portsmouth, NH 03801-5421
Phone
(603) 436-0099
NPI assigned
Jul 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Authorized official

Name
Elazar Fischer
Title
Authorized Official
Phone
(617) 895-9122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

928 South St
Portsmouth, NH 03801-5421

Mailing address

1135 E Veterans Hwy Ste 1
Jackson, NJ 08527-5090

Other names 1

  • Edgewood Center for Rehab and Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221018002846 NH Part A Provider - Skilled Nursing Facility 4981070802 Practice locations: Portsmouth, NH

Skilled nursing facility certification: CCN 305022

Legal name
EDGEWOOD REHAB AND HEALTHCARE CENTER LLC
Doing business as
EDGEWOOD CENTER FOR REHAB & HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 13, 1972
Last certification
Mar 14, 2024
Beds
156
Ownership / control type
Corporation
Multi-facility organization
Green Tree Healthcare Management
Organization structure
LLCProprietary
Incorporated
May 19, 2022 in DE
Enrollment address
928 South St
Portsmouth, NH 03801-5421
Nursing home name
EDGEWOOD CENTRE (THE)
Affiliated entity
GREEN TREE HEALTH MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edgewood Centre (the)CCN 305022
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 13, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
156139.9 residents per day on average
Chain
Green Tree Health Management8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1135 E Veterans Hwy
Ste 1
Jackson, NJ 08527

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
SJ Family Trust Organization, Lakewood, NJ Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 24%
Adp of the SNF Aug 1, 2022
Ads Capital Trust Organization, Brooklyn, NY Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 24%
Adp of the SNF Aug 1, 2022
SJ Healthcare Capital LLC Organization, Jackson, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 25.25%
Adp of the SNF Aug 1, 2022
Patricia C Robillard Individual Operational/Managerial Control Aug 1, 2022
Adp of the SNF Jul 17, 2025
PC8 Capital Group LLC Organization, Jackson, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 25.25%
Adp of the SNF Aug 1, 2022
Aharon Stern Individual Corporate OfficerCeo Aug 1, 2022
Operational/Managerial Control Aug 1, 2022
Edgewood NH Opco Holdco LLC Organization, Jackson, NJ LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2022 100%
Dasay 2019 Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Aug 1, 2022 16.25%
Individual Adp of the SNF Jul 17, 2025
Simon J Stern Individual Corporate OfficerPresident Aug 1, 2022
Operational/Managerial Control Aug 1, 2022
Gamta 2020 Trust Organization, Lakewood, NJ 5% Or Greater Indirect Ownership Interest Aug 1, 2022 16.25%

Facilities with the same owner 10

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

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": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1689309304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 E VETERANS HWY STE 1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085275090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 SOUTH ST",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015421",
            "telephone_number": "603-436-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD REHAB AND HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "ELAZAR",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "617-895-9122"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Center for Rehab and Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.