NPIMap

Organization Active NPI

The Bay at Waters Edge Health and Rehabilitation LLC

  • Skilled Nursing Facility
  • Kenosha, WI
National Provider Identifier
1700312436
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE BAY AT WATERS EDGE HEALTH AND REHABILITATION LLC
Practice address
3415 Sheridan Rd
Kenosha, WI 53140
Phone
(262) 657-6175
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Menachem Ruvel
Title
Manager
Phone
(516) 605-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3415 Sheridan Rd
Kenosha, WI 53140

Mailing address

3415 Sheridan Rd
Kenosha, WI 53140-1924
Phone (262) 657-6175

Other names 1

  • Waters Edge Health and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180613000532 WI Part A Provider - Skilled Nursing Facility 7416202585 Practice locations: Kenosha, WI

Skilled nursing facility certification: CCN 525281

Legal name
THE BAY AT WATERS EDGE HEALTH AND REHABILITATION LLC
Doing business as
WATERS EDGE HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1976
Last certification
Aug 5, 2024
Beds
128
Ownership / control type
Corporation
Multi-facility organization
CHAMPION HEALTH CARE
Organization structure
LLCProprietary
Incorporated
Feb 1, 2018 in WI
Enrollment address
3415 Sheridan Rd
Kenosha, WI 53140-1924
Nursing home name
WATERS EDGE HEALTH AND REHABILITATION CENTER
Affiliated entity
CHAMPION CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Waters Edge Health and Rehabilitation CenterCCN 525281
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12896.4 residents per day on average
Chain
Champion Care22 facilities in the chain
Special focus status
SFF Candidate
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $54,055

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Champion Care LLC Organization, Rockville Centre, NY LLC 5% Or Greater Direct Ownership Interest Feb 3, 2018 100%
Operational/Managerial Control Feb 3, 2018 100%
Menachem Ruvel Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2018 50%
Corporate DirectorManaging Member Feb 1, 2018 50%
Operational/Managerial ControlManaging Member Feb 1, 2018 50%
Yisroel N Weinberg Individual 5% Or Greater Indirect Ownership InterestManaging Member Feb 1, 2018 50%
Corporate DirectorManaging Member Feb 1, 2018 50%
Operational/Managerial ControlManaging Member Feb 1, 2018 50%

Facilities with the same owner 10

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

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": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1700312436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401924",
            "telephone_number": "262-657-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SHERIDAN RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53140",
            "telephone_number": "262-657-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BAY AT WATERS EDGE HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "RUVEL",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-605-9800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waters Edge Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.