Active NPI
Asrv, LLC
- Skilled Nursing Facility
- San Juan Capistrano, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ASRV, LLC
- Practice address
- 31741 Rancho Viejo Rd
San Juan Capistrano, CA 92675-6722 - Phone
- (949) 248-8855
- NPI assigned
- Dec 29, 2020
- Last updated
- Dec 29, 2020
- 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
- Jeffrey Bradshaw
- Title
- Manager
- Phone
- (949) 347-7100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
31741 Rancho Viejo Rd
San Juan Capistrano, CA 92675-6722
Mailing address
28202 Cabot Rd Ste 412
Laguna Niguel, CA 92677-1271
Phone (949) 370-7130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220309000590 | CA | Part A Provider - Skilled Nursing Facility | 8224422217 | Practice locations: San Juan Capistrano, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1720675317. Details of each certification follow.
Skilled nursing facility certification: CCN 555763
- Legal name
- ASRV LLC
- Doing business as
- SAN JUAN HILLS HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Aug 31, 2000
- Last certification
- Nov 15, 2024
- Beds
- 45
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 31741 Rancho Viejo Rd
San Juan Capistrano, CA 92675-6722 - Nursing home name
- SAN JUAN HILLS HEALTHCARE CENTER
- Affiliated entity
- ASPEN SKILLED HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- San Juan Hills Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Limited Liability company
- Certified
- Aug 31, 2000
- Medicare certification status
- Active
- Certified beds
- 45
- Chain
- Aspen Skilled 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 |
|---|---|---|---|
| 05D0964888 | Asrv, LLC Dba San Juan Hills Healthcare Center | Certificate of waiver | Sep 6, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 21
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 |
|---|---|---|---|
| Craig Orgill | Indirect Ownership Interest | Nov 3, 2021 | 1.3% |
| Jared Kirkwood | Indirect Ownership Interest | Nov 3, 2021 | 0.3% |
| Eric Elsner | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
| Jeffrey J Bradshaw | Managing Control - Governing Body | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Indirect Ownership Interest | Nov 3, 2021 | 22.25% | |
| Timothy Caslmon | Operational/Managerial Control | Jan 1, 2023 | |
| Managing Control - Governing Body | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Ryan M Case | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Nov 3, 2021 | 31.77% | |
| Marcus J Paxman | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Apr 1, 2022 | 0.01% | |
| Huan C Guu | Adp of the SNF | Jun 1, 2009 | |
| Aspen Skilled Healthcare Inc | Indirect Ownership Interest | Nov 3, 2021 | 100% |
| Aspen Healthcare Services LLC | Adp of the SNF | Jan 1, 2023 | |
| Lanie Sta Ana | Operational/Managerial Control | Feb 1, 2022 | |
| Adp of the SNF | Feb 1, 2022 | ||
| Spencer Nordfelt | Operational/Managerial Control | Jan 3, 2022 | |
| Adp of the SNF | Jan 3, 2022 | ||
| Sacc LLC | Indirect Ownership Interest | Nov 3, 2021 | 100% |
| Stephen Thompson | Operational/Managerial Control | Jan 1, 2023 | |
| Managing Control - Governing Body | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| East West Bank | Adp of the SNF | Aug 6, 2020 | |
| Frank Jurado | Adp of the SNF | Jan 1, 2023 | |
| Vern J Brady | Adp of the SNF | Jan 1, 2023 | |
| Indirect Ownership Interest | Nov 3, 2021 | 31.95% | |
| Asrv LLC | Operational/Managerial Control | Nov 3, 2021 | |
| Adp of the SNF | Nov 3, 2021 | ||
| Direct Ownership Interest | Nov 3, 2021 | 100% | |
| Shruty Parti | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
| Peter Bradshaw | Indirect Ownership Interest | Jul 7, 2023 | 0.09% |
| Rajesh Parti | Indirect Ownership Interest | Nov 3, 2021 | 4.08% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Laguna Hills, CA
- NPI 1013097260
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609200000000",
"number": "1720675317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28202 CABOT RD STE 412",
"city": "LAGUNA NIGUEL",
"state": "CA",
"postal_code": "926771271",
"telephone_number": "949-370-7130",
"fax_number": "949-347-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31741 RANCHO VIEJO RD",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926756722",
"telephone_number": "949-248-8855"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASRV, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A",
"authorized_official_last_name": "BRADSHAW",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "949-347-7100"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan Capistrano, CA
- Apex Chiropractic & Sci Wellness Center
- Apex Health Inc.
- Aquaphire Inc (Orange County Skin Lab)
- Arv Assisted Living, Inc. (San Juan)
- James H Ashizawa, MD
- Kacie Astorga, NP
- At Your Service Healthcare, LLC
- Atencio / Maclean Services, Inc.
- William Glenn Atkins III
- Aureus Acquisition III, LP (Brighton Gardenof San Juan Capistrano)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; 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.