Beachside Opco LLC
Organization Active NPI Skilled Nursing Facility · New Smyrna Beach, FL
NPI 1700565678 · NPPES record last updated Apr 29, 2026
Key facts
- NPI
- 1700565678
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- BEACHSIDE OPCO LLC
- Practice address
- 2810 S Atlantic Ave
New Smyrna Beach, FL 32169-3446 - Phone
- (954) 300-3878
- NPI assigned
- Jul 17, 2023
- Organization subpart
- No
Authorized official
- Name
- Mr. Jacob Bengio
- Title
- Cfo
- Phone
- (305) 562-5501
Owners & managing parties with NPI records 1
-
Husam Eddin, M.D
Affiliated clinicians 4
-
Mallory Anne McInnes, M.D.
-
Kristin L Wulff, MD
Medicare Care Compare: Nursing home
- Listed as
- Beachside Center for Rehabilitation and Nursing
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 1, 1980
- Medicare certification status
- Active
- Certified beds
- 239 · 165.5 residents per day on average
- Chain
- Ventura Services
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0268046 | Beachside Opco LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Skilled nursing facility certification: CCN 105038
- Legal name
- BEACHSIDE OPCO LLC
- Doing business as
- BEACHSIDE CENTER FOR REHABILITATION AND NURSING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 1, 1980
- Last certification
- Mar 28, 2024
- Beds
- 239
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 2810 S Atlantic Ave
New Smyrna Beach, FL 32169-3446 - Nursing home name
- BEACHSIDE CENTER FOR REHABILITATION AND NURSING
- Affiliated entity
- VENTURA SERVICES
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Agrp - 2011 TR |
Trustee of the SNF | Jan 11, 2024 | |
| Indirect Ownership Interest | Jan 11, 2024 | 41% | |
| Jeremie Paritzky |
Operational/Managerial Control | Jan 11, 2024 | |
| Jacob Bengio |
Operational/Managerial Control | Jan 11, 2024 | |
| Tasha Mitchell |
Operational/Managerial Control | Jun 24, 2024 | |
| Adp of the SNF | Jun 24, 2024 | ||
| Tessler Associates LLC |
Adp of the SNF | Jan 11, 2024 | |
| Indirect Ownership Interest | Jan 11, 2024 | 13% | |
| Beachside Holdco LLC |
5% Or Greater Direct Ownership Interest | Jan 11, 2024 | 100% |
| Deborah Philipson 2011 Family Trust |
Trustee of the SNF | Jan 11, 2024 | |
| Adp of the SNF | Jan 11, 2024 | ||
| Indirect Ownership Interest | Jan 11, 2024 | 41% | |
| Aron Tessler |
Adp of the SNF | Jan 11, 2024 | |
| Indirect Ownership Interest | Jan 11, 2024 | 6.5% | |
| Ventura Services - Florida, LLC |
Adp of the SNF | Jan 11, 2024 | |
| Richards Mitchell & Cross PA |
Adp of the SNF | Jan 11, 2024 | |
| Husam E Eddin |
Adp of the SNF | Jan 11, 2024 | |
| Philipson Family Limited Liability Company, LLC |
Adp of the SNF | Jan 11, 2024 | |
| Indirect Ownership Interest | Jan 11, 2024 | 87% | |
| Naomi Tessler |
Adp of the SNF | Jan 11, 2024 | |
| Indirect Ownership Interest | Jan 11, 2024 | 6.5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240624004380 | FL | Part a Provider - Skilled Nursing Facility | 9335682921 | Practice locations: New Smyrna Beach, FL |
National Provider Directory
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
2810 S Atlantic Ave
New Smyrna Beach, FL 32169-3446
Mailing address
2901 Stirling Rd Ste 200
Fort Lauderdale, FL 33312-6529
Phone (954) 300-3878
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
Other providers in New Smyrna Beach, FL
- Grey Asher Batchelder
- Bay View Urgent Care LLC
- Be Well Chiropractic, Inc.
- Beach Vision Holdings, PA
- Beachside Medical Center
- Beachside Therapy Services, LLC
- Michelle Leigh Beaulieu
- Katherine Ann Becker
- Behavior Functional Focus Clinic
- Joseph C. Beissel
All providers in New Smyrna Beach, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.