Active NPI
Marina Garden Nursing Center, Inc.
- Skilled Nursing Facility
- Alameda, CA
National Provider Identifier
1699770867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 206013653
- Legal business name
- MARINA GARDEN NURSING CENTER, INC.
- Doing business as
- MARINA GARDEN NURSING CENTER
- Practice address
- 3201 Fernside Blvd
Alameda, CA 94501-1709 - Phone
- (510) 523-2363
- Fax
- (510) 865-5076
- NPI assigned
- Jun 15, 2005
- 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
- Mrs. Belinda Leung, RN, CRRN, MBA
- Title
- Administrator
- Phone
- (510) 536-1838
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 206013653 | CA | Primary |
Addresses
Primary practice location
3201 Fernside Blvd
Alameda, CA 94501-1709
Mailing address
3201 Fernside Blvd
Alameda, CA 94501-1709
Phone (510) 536-1838
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55461H | Medicaid | CA |
Other names 1
- MARINA GARDEN NURSING 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 |
|---|---|---|---|---|
| O20040422000115 | CA | Part A Provider - Skilled Nursing Facility | 3577559921 | Practice locations: Alameda, CA |
Skilled nursing facility certification: CCN 555461
- Legal name
- MARINA GARDEN NURSING CENTER, INC.
- Doing business as
- MARINA GARDEN NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 27, 1991
- Last certification
- Nov 21, 2024
- Beds
- 32
- Ownership / control type
- Corporation
- Most recent change of ownership
- Jun 1, 2004
- Organization structure
- Corporation
- Incorporated
- Mar 26, 2004 in CA
- Enrollment address
- 3201 Fernside Blvd.
Alameda, CA 94501-1709 - Nursing home name
- MARINA GARDEN NURSING CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Marina Garden Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- May 27, 1991
- Medicare certification status
- Active
- Certified beds
- 32
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Belinda Leung | 5% Or Greater Direct Ownership Interest | Apr 1, 2004 | 50% |
| Corporate Officer | Apr 1, 2004 | 50% | |
| Corporate Director | Apr 1, 2004 | 50% | |
| W-2 Managing Employee | Apr 1, 2004 | 50% | |
| Operational/Managerial Control | Apr 1, 2004 | 50% | |
| Kenneth Leung | 5% Or Greater Direct Ownership Interest | Apr 1, 2004 | 50% |
| Corporate Officer | Apr 1, 2004 | 50% | |
| Corporate Director | Apr 1, 2004 | 50% | |
| W-2 Managing Employee | Apr 1, 2004 | 50% | |
| Operational/Managerial Control | Apr 1, 2004 | 50% |
Practitioners & affiliated clinicians
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": "1118793600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1251417600000",
"number": "1699770867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 FERNSIDE BLVD",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011709",
"telephone_number": "510-536-1838",
"fax_number": "510-536-1816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 FERNSIDE BLVD",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011709",
"telephone_number": "510-523-2363",
"fax_number": "510-865-5076"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARINA GARDEN NURSING CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-15",
"last_updated": "2009-08-28",
"status": "A",
"authorized_official_last_name": "LEUNG",
"authorized_official_first_name": "BELINDA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "510-536-1838",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN, CRRN, MBA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "206013653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55461H",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MARINA GARDEN NURSING CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.