Organization Active NPI

Blooming Oaks Wellness & Rehabilitation LLC

  • Skilled Nursing Facility
  • Saint Louis, MO
National Provider Identifier
1699528422
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BLOOMING OAKS WELLNESS & REHABILITATION LLC
Practice address
9350 Green Park Rd
Saint Louis, MO 63123-7211
Phone
(314) 845-0900
Fax
(314) 845-0901
NPI assigned
Apr 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
David Garetz
Title
Cfo
Phone
(323) 987-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

9350 Green Park Rd
Saint Louis, MO 63123-7211

Mailing address

9350 Green Park Rd
Saint Louis, MO 63123-7211
Phone (314) 845-0900

Other names 1

  • Bluebird Wellness & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241031000487 MO Part A Provider - Skilled Nursing Facility 9537692447 Practice locations: Saint Louis, MO

Skilled nursing facility certification: CCN 265703

Legal name
BLOOMING OAKS WELLNESS & REHABILITATION LLC
Doing business as
BLUEBIRD WELLNESS AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 21, 2000
Last certification
Feb 13, 2024
Beds
188
Ownership / control type
Limited Liability Corporation
Multi-facility organization
OPCP
Organization structure
LLCProprietary
Enrollment address
9350 Green Park Rd
Saint Louis, MO 63123-7211
Nursing home name
BLUEBIRD WELLNESS AND REHABILITATION
Affiliated entity
OPCO SKILLED MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bluebird Wellness and RehabilitationCCN 265703
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 21, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
188159.0 residents per day on average
Chain
Opco Skilled Management66 facilities in the chain
Penalties (3 years)
2Fines totaling $234,836

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
26D0952543Bluebird Wellness and Rehabilitation9350 Green Park Road, Saint Louis, MO 63123Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Sesame Realty Trust Organization, Los Angeles, CA 5% Or Greater Mortgage Interest Jul 30, 2024 22%
Adp of the SNF Oct 31, 2024
Blooming Willow Partners LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 30, 2024 97%
Harold Lutz Individual Operational/Managerial Control Jul 30, 2024
Adp of the SNF Jul 30, 2024
Knobel Realty Trust Organization, Los Angeles, CA 5% Or Greater Mortgage Interest Jul 30, 2024 20%
Adp of the SNF Oct 31, 2024
Iqbal I Amin Individual Operational/Managerial Control Jul 30, 2024
Adp of the SNF Jul 30, 2024
Pas B Sol Trust Organization, Los Angeles, CA 5% Or Greater Indirect Ownership Interest Jul 30, 2024 34.15%
9350 Green Park Road Mo LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jul 30, 2024 100%
Adp of the SNF Oct 31, 2024
Derhoben Trust Organization, Los Angeles, CA 5% Or Greater Indirect Ownership Interest Jul 30, 2024 63.42%
Willowbrook Investors LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jul 30, 2024 100%
Adp of the SNF Oct 31, 2024
Adam Mindle Individual 5% Or Greater Mortgage InterestTrustee Jul 30, 2024
Mordechai Kaplan Individual 5% Or Greater Mortgage InterestTrustee Jul 30, 2024
Niv Davidovich Individual 5% Or Greater Indirect Ownership InterestTrustee of Derhoben Trust Jul 30, 2024
Brook Partners LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jul 30, 2024 97%
Adp of the SNF Oct 31, 2024
Elizabeth Hagins Individual 5% Or Greater Mortgage InterestTrustee Jul 30, 2024
Linz Trust Organization, Los Angeles, CA 5% Or Greater Mortgage Interest Jul 30, 2024 34.15%
Adp of the SNF Oct 31, 2024
Jennifer Sternshein Individual 5% Or Greater Indirect Ownership InterestTrustee of Pas B Sol Trust Jul 30, 2024
David Garetz Individual Operational/Managerial Control Jul 30, 2024
Adp of the SNF Jul 30, 2024
Indirect Ownership Interest Jul 30, 2024 2%
Rembrandt Realty Trust Organization, Los Angeles, CA 5% Or Greater Mortgage Interest Jul 30, 2024 21.42%
Adp of the SNF Oct 31, 2024
Wildflower Healthcare LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 30, 2024 100%
Caroline Zimmerman Individual 5% Or Greater Mortgage InterestTrustee Jul 30, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 2

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

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": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1699528422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 GREEN PARK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237211",
            "telephone_number": "314-845-0900",
            "fax_number": "314-845-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 GREEN PARK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237211",
            "telephone_number": "314-845-0900",
            "fax_number": "314-845-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING OAKS WELLNESS & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "GARETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-987-5954"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebird Wellness & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.