Active NPI
St Amaro Opco LLC
Doing business as Vivo Healthcare Wauchula
- Skilled Nursing Facility
- Wauchula, FL
National Provider Identifier
1700563517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ST AMARO OPCO LLC
- Doing business as
- Vivo Healthcare Wauchula
- Practice address
- 401 Orange PL
Wauchula, FL 33873-3417 - Phone
- (863) 773-3231
- NPI assigned
- Jul 3, 2023
- Last updated
- Jul 3, 2023
- 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
- Josef Cuikier
- Title
- Member
- Phone
- (732) 200-1155
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
401 Orange PL
Wauchula, FL 33873-3417
Mailing address
401 Orange PL
Wauchula, FL 33873-3417
Other names 1
- Vivo Healthcare Wauchula
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231111000565 | FL | Part A Provider - Skilled Nursing Facility | 3779930896 | Practice locations: Wauchula, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1700563517. Details of each certification follow.
Skilled nursing facility certification: CCN 105362
- Legal name
- ST AMARO OPCO LLC
- Doing business as
- VIVO HEALTHCARE WAUCHULA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 19, 1980
- Last certification
- Jun 27, 2024
- Beds
- 79
- Ownership / control type
- Corporation
- Multi-facility organization
- VIVO HEALTHCARE
- Most recent change of ownership
- Sep 1, 2023
- Organization structure
- LLC
- Enrollment address
- 401 Orange PL
Wauchula, FL 33873-3417 - Nursing home name
- VIVO HEALTHCARE WAUCHULA
- Affiliated entity
- VIVO HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Vivo Healthcare Wauchula
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 19, 1980
- Medicare certification status
- Active
- Certified beds
- 79
- Chain
- Vivo Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0293196 | Vivo Healthcare Wauchula | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 16
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 |
|---|---|---|---|
| St Amaro Holdco LLC | 5% Or Greater Direct Ownership Interest | Sep 1, 2023 | 100% |
| NMJ Irrv TR II | 5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 6% |
| Vivo Healthcare Consulting LLC | Adp of the SNF | Sep 1, 2023 | |
| Donald B Geldart | Adp of the SNF | Sep 1, 2023 | |
| Benjamin Gluck | 5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 12% |
| Operational/Managerial Control | Sep 1, 2023 | ||
| Josef Cukier | 5% Or Greater Indirect Ownership Interest | Sep 4, 2023 | 49% |
| Corporate Officer | Sep 1, 2023 | ||
| Operational/Managerial Control | Sep 1, 2023 | ||
| NMJ Holdings LLC | Direct Ownership Interest | Sep 1, 2023 | 5% |
| Jeffrey H Kagan | Direct Ownership Interest | Sep 1, 2023 | 4.9% |
| Jek Holdings LLC | Direct Ownership Interest | Sep 1, 2023 | 5% |
| Jek Irrv TR II | Direct Ownership Interest | Sep 1, 2023 | |
| Summation Financial Services LLC | Adp of the SNF | Sep 1, 2023 | |
| Forvis Mazars LLP | Adp of the SNF | Sep 1, 2023 | |
| Pease Bell Cpas LLC | Adp of the SNF | Sep 1, 2023 | |
| Direct Ownership Interest | Sep 1, 2023 | 95.1% | |
| Shalom Friedland | 5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 19% |
| Operational/Managerial Control | Sep 1, 2023 | ||
| Amy E Messier | Adp of the SNF | Sep 1, 2023 |
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 15
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Vivo Healthcare Ft Pierce
- Skilled Nursing Facility
- Fort Pierce, FL
- NPI 1588341382
NMJ Irrv TR II
-
dba Vivo Healthcare Gandy
- Skilled Nursing Facility
- Tampa, FL
- NPI 1558158501
NMJ Irrv TR II
-
dba Havens at Pensacola
- Skilled Nursing Facility
- Pensacola, FL
- NPI 1851142392
NMJ Irrv TR II
-
dba Vivo Healthcare Meadows
- Skilled Nursing Facility
- Sarasota, FL
- NPI 1376342246
NMJ Irrv TR II
-
dba Vivo Healthcare Winter Haven
- Skilled Nursing Facility
- Winter Haven, FL
- NPI 1336826148
NMJ Irrv TR II
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Lakeland, FL
- NPI 1669657409
Nursing home
-
- Internal Medicine Physician
- Sebring, FL
- NPI 1215441225
Nursing home
-
- Internal Medicine Physician
- Clearwater, FL
- NPI 1235366360
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1688342400000",
"number": "1700563517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 ORANGE PL",
"city": "WAUCHULA",
"state": "FL",
"postal_code": "338733417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 ORANGE PL",
"city": "WAUCHULA",
"state": "FL",
"postal_code": "338733417",
"telephone_number": "863-773-3231"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST AMARO OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A",
"authorized_official_last_name": "CUIKIER",
"authorized_official_first_name": "JOSEF",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "732-200-1155"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Vivo Healthcare Wauchula",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wauchula, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.