Active NPI
Excell Post Acute LLC
- Skilled Nursing Facility
- Oakland, CA
National Provider Identifier
1699345900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- EXCELL POST ACUTE LLC
- Practice address
- 3025 High St
Oakland, CA 94619-1807 - Phone
- (510) 261-5200
- NPI assigned
- Jun 29, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Johnson
- Title
- Ceo
- Phone
- (310) 266-1080
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
3025 High St
Oakland, CA 94619-1807
Mailing address
3050 Saturn St Ste 201
Brea, CA 92821-6278
Phone (714) 577-3880
Other names 1
- Excell Health Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211006002032 | CA | Part A Provider - Skilled Nursing Facility | 8628476587 | Practice locations: Oakland, CA |
Skilled nursing facility certification: CCN 056170
- Legal name
- EXCELL POST ACUTE LLC
- Doing business as
- EXCELL HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 4, 1970
- Last certification
- Nov 21, 2024
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Jul 1, 2021
- Organization structure
- LLC
- Incorporated
- Feb 11, 2021 in CA
- Enrollment address
- 3025 High St
Oakland, CA 94619-1807 - Nursing home name
- EXCELL HEALTH CARE CENTER
- Affiliated entity
- DAVID JOHNSON
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Excell Health Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 4, 1970
- Medicare certification status
- Active
- Certified beds
- 99
- Chain
- David Johnson
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| SMV Oakland Excell LLC | Adp of the SNF | Jan 1, 2005 | |
| David a Johnson | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 50% |
| Operational/Managerial Control | Feb 11, 2021 | ||
| Adp of the SNF | Feb 11, 2021 | ||
| Micheal D Oxford | Operational/Managerial Control | Jan 3, 2022 | |
| Adp of the SNF | Jan 3, 2022 | ||
| Frank a Johnson | 5% Or Greater Indirect Ownership Interest | Feb 11, 2021 | 50% |
| Operational/Managerial Control | Feb 11, 2021 | ||
| Joshua Kochek | Operational/Managerial Control | Apr 1, 2022 | |
| Adp of the SNF | Apr 1, 2022 | ||
| Sun Meridian Management Services LLC | Adp of the SNF | Mar 22, 2021 | |
| Adrian Dehghanmanesh | Corporate Officer | Jul 1, 2021 | 100% |
| Operational/Managerial Control | Jun 1, 2021 | ||
| Adp of the SNF | Jun 1, 2021 | ||
| Mary Farrales | Adp of the SNF | Jan 1, 2023 | |
| Elma T Conway | Operational/Managerial Control | Feb 26, 2022 | |
| Adp of the SNF | Feb 26, 2022 | ||
| Excell Post Acute LLC | 5% Or Greater Direct Ownership Interest | Jul 1, 2021 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1624924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624924800000",
"number": "1699345900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 SATURN ST STE 201",
"city": "BREA",
"state": "CA",
"postal_code": "928216278",
"telephone_number": "714-577-3880",
"fax_number": "714-577-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3025 HIGH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946191807",
"telephone_number": "510-261-5200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCELL POST ACUTE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-08",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "310-266-1080"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Excell Health Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.