NPIMap

Organization Active NPI

Middleburg Rehabilitation and Nursing Center LLC

Doing business as Middleburg Rehabilitation and Nursing Center

  • Skilled Nursing Facility
  • Middleburg, FL
National Provider Identifier
1720713175
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MIDDLEBURG REHABILITATION AND NURSING CENTER LLC
Doing business as
Middleburg Rehabilitation and Nursing Center
Practice address
1280 Henley Rd
Middleburg, FL 32068-7886
Phone
(904) 600-3798
Fax
(904) 600-3799
NPI assigned
Jul 20, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Moshe Kelman
Title
Member
Phone
(917) 613-1662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1280 Henley Rd
Middleburg, FL 32068-7886

Mailing address

1280 Henley Rd
Middleburg, FL 32068-7886
Phone (904) 600-3798

Other identifiers 1

IdentifierTypeStateIssuer
130471082OtherFLLICENSE

Other names 1

  • Middleburg Rehabilitation and Nursing Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://shcofmiddleburg.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221125000522 FL Part A Provider - Skilled Nursing Facility 9335517291 Practice locations: Middleburg, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720713175. Details of each certification follow.

Skilled nursing facility certification: CCN 106143

Legal name
MIDDLEBURG REHABILITATION AND NURSING CENTER LLC
Doing business as
MIDDLEBURG REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 2, 2020
Last certification
Mar 14, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Topaz Fiscal Service
Organization structure
LLCProprietary
Incorporated
Jul 7, 2022 in FL
Enrollment address
1280 Henley Rd
Middleburg, FL 32068-7886
Nursing home name
MIDDLEBURG REHABILITATION AND NURSING CENTER
Affiliated entity
BENJAMIN LANDA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Middleburg Rehabilitation and Nursing CenterCCN 106143 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 2, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120117.8 residents per day on average
Chain
Benjamin Landa48 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2181250Middleburg Rehabilitation and Nursing Center LLC1280 Henley Rd, Middleburg, FL 32068Certificate of waiverMar 30, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Mkja Opco LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 8.98%
Alexander Platschek Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 25%
Judy Landa Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 9.99%
Jacksonville 4 Member Opco LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 60%
Hal Brecher Individual Corporate Officer Oct 7, 2022 100%
Shlomo Lowy Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 16.5%
Jacksonville 4 Opco Partners LLC Organization, Brooklyn, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2022 100%
ZBL-18 LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 10%
Goldie Platschek Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 20.16%
Jflnho Capital Group, LLC Organization, Minneola, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2022 9.99%
Rpja Opco LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 12.1%
Moshe Kelman Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 16.49%
Erica Henderson Individual W-2 Managing EmployeeAdministrator Oct 8, 2022 100%
Gpja Opco LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 12.1%
Middleburg Rehabilitation and Nursing Member, LLC Organization, Middleburg, FL Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 7, 2022 100%
Apja Opco LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 15%
Richard Platschek Individual 5% Or Greater Indirect Ownership Interest Oct 7, 2022 20.16%
Slja Opco LLC Organization, Dallas, TX Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 7, 2022 9.9%
Benjamin Landa Individual 5% Or Greater Indirect Ownership Interest Oct 8, 2022 10.01%
Flnho Capital Group LLC Organization, Minneola, NY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2022 10.01%

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1720713175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 HENLEY RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687886",
            "telephone_number": "904-600-3798",
            "fax_number": "904-600-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 HENLEY RD",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687886",
            "telephone_number": "904-600-3798",
            "fax_number": "904-600-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBURG REHABILITATION AND NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "KELMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-613-1662"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "130471082",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://shcofmiddleburg.com/",
            "affiliation": "N",
            "address_1": "1280 Henley Rd",
            "city": "Middleburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320687886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Middleburg Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg, FL

Sources for this page

Verify at the official NPI Registry.