Park Avenue Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2902306N Issued in NY

Legal business name

PARK AVENUE OPERATING COMPANY LLC

Practice address

425 National Blvd
Long Beach, NY 11561-2031

Phone

(516) 431-2600

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey Goldstein

Title

Officer

Phone

(516) 869-3700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335819

Legal name

PARK AVENUE OPERATING COMPANY LLC

Doing business as

PARK AVENUE EXTENDED CARE FACILITY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 14, 1999

Last certification

Nov 4, 2024

Beds

240

Ownership / control type

Corporation

Organization structure

LLCProprietary

Incorporated

Jul 23, 2004 in NY

Enrollment address

425 National Blvd
Long Beach, NY 11561-2031

Nursing home name

PARK AVENUE EXTENDED CARE FACILITY

Listed as

Park Avenue Extended Care FacilityCCN 335819 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 14, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

240230.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 6

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

Practitioners 2

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

• Polina Khanina, MD

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1285679498
  NPD (past)
• Shiphali Rohatgi, MD

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1548279094
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Polina Khanina, MD

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1285679498

  Nursing home

  Care Compare affiliation
• Shiphali Rohatgi, MD

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1548279094

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1720111479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NATIONAL BLVD",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NATIONAL BLVD",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612031",
            "telephone_number": "516-431-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "516-869-3700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "2902306N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02001229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Nicole Paganini
• Monica Suniti Pal, PH.D.
• Joanne Paradiso, B.S. PHARMACY, MBA
• Park Ave Eyeland East, LLC
• Park Avenue Eyeland Inc.
• Jamie Parnell, MHC
• Nicole Kristina Pasceri, M.S.ED.
• Mauricio Patino, LMT
• Patterns With Purpose Mental Health Counseling, PLLC
• Paws 4 Peds PT & OT PLLC

• Skilled Nursing Facility in Long Beach, NY
• Providers in Long Beach, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.

Verify at the official NPI Registry.