NPIMap

Organization Active NPI

Riverside Rehabilitation and Healthcare LLC

  • Skilled Nursing Facility
  • Taylor, PA
National Provider Identifier
1710692082
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RIVERSIDE REHABILITATION AND HEALTHCARE LLC
Practice address
500 W Hospital St
Taylor, PA 18517-2012
Phone
(570) 562-2102
NPI assigned
Jan 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Shai Berdugo
Title
Authorized Official
Phone
(570) 562-2102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

500 W Hospital St
Taylor, PA 18517-2012

Mailing address

575 Route 70 FL 2
Brick, NJ 08723-4042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230617000151 PA Part A Provider - Skilled Nursing Facility 7719345073 Practice locations: Taylor, PA

Skilled nursing facility certification: CCN 395564

Legal name
RIVERSIDE REHABILITATION AND HEALTHCARE LLC
Doing business as
OAK RIDGE REHABILITATION & HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 13, 1983
Last certification
Apr 25, 2025
Beds
142
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Century IV Holdco LLC
Organization structure
LLCProprietary
Enrollment address
500 West Hospital St
Taylor, PA 18517-2012
Nursing home name
OAK RIDGE REHABILITATION & HEALTHCARE CENTER
Affiliated entity
CENTURY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oak Ridge Rehabilitation & Healthcare CenterCCN 395564
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 13, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
142134.2 residents per day on average
Chain
Century Healthcare9 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
3Fines totaling $104,143

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 36

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

NameRoleSinceShare
Organization, Toms River, NJ Adp of the SNF May 1, 2023
Individual Trustee of the SNF May 1, 2023
Organization, Brick, NJ LLC, Management services company Adp of the SNF Mar 4, 2025
Century IV TBD Holdco LLC Organization, Brick, NJ LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2023 100%
Shai Berdugo Individual 5% Or Greater Indirect Ownership Interest Mar 4, 2025 47.33%
Corporate OfficerReimbursement Officer May 1, 2023
Operational/Managerial Control Mar 4, 2025
Managing Control - Governing BodyManager of the Manager Mar 4, 2025
Adp of the SNF Mar 4, 2025
Individual Indirect Ownership Interest May 1, 2023 1.45%
Organization, Toms River, NJ LLC Adp of the SNF May 1, 2023
Organization, Toms River, NJ LLC, Holding company Adp of the SNF May 1, 2023
Individual Indirect Ownership Interest May 1, 2023 1.45%
Organization, Toms River, NJ Indirect Ownership Interest May 1, 2023 4.99%
Individual Indirect Ownership Interest May 1, 2023 0.36%
Organization, Toms River, NJ Indirect Ownership Interest May 1, 2023 2.91%
Individual Indirect Ownership Interest May 1, 2023 1.45%
Organization, Toms River, NJ Adp of the SNF May 1, 2023
Organization, Toms River, NJ Indirect Ownership Interest May 1, 2023 4.99%
Guy M Fasciana Individual Operational/Managerial Control May 1, 2023
Adp of the SNF Jun 18, 2025
Organization, Toms River, NJ Adp of the SNF May 1, 2023
Organization, Brick, NJ LLC, Holding company Adp of the SNF May 1, 2023
Organization, Toms River, NJ Indirect Ownership Interest May 1, 2023 4.99%
Organization, Toms River, NJ Indirect Ownership Interest May 1, 2023 4.99%
Organization, Brick, NJ LLC, Holding company Adp of the SNF May 1, 2023
Individual Indirect Ownership Interest May 1, 2023 1.45%
Individual Trustee of the SNF May 1, 2023
Individual Indirect Ownership Interest May 1, 2023 4.36%
Kulanu Oc Trust Organization, Toms River, NJ 5% Or Greater Indirect Ownership Interest May 1, 2023 14.5%
Koryn Mascioli Individual Operational/Managerial Control Mar 31, 2025
Adp of the SNF Jun 18, 2025
Individual Indirect Ownership Interest May 1, 2023 3.27%
Individual Trustee of the SNF May 1, 2023
Organization, Toms River, NJ Adp of the SNF May 1, 2023
Individual Trustee of the SNF May 1, 2023
Organization, Toms River, NJ Adp of the SNF May 1, 2023
Individual Indirect Ownership Interest May 1, 2023 1.45%
Individual Trustee of the SNF May 1, 2023
Century IV Pennsylvania Holdco LLC Organization, Brick, NJ LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest May 1, 2023 100%
Efraim Klein Individual 5% Or Greater Indirect Ownership Interest May 1, 2023 29%
Corporate OfficerCeo May 1, 2023
Individual Trustee of the SNF May 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 8

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

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 6

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": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1710692082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROUTE 70 FL 2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W HOSPITAL ST",
            "city": "TAYLOR",
            "state": "PA",
            "postal_code": "185172012",
            "telephone_number": "570-562-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE REHABILITATION AND HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "BERDUGO",
        "authorized_official_first_name": "SHAI",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "570-562-2102"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, PA

Sources for this page

Verify at the official NPI Registry.