Organization Active NPI

Bayberry Nursing Home

  • Skilled Nursing Facility
  • New Rochelle, NY
National Provider Identifier
1750387916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5904317N Issued in NY
Legal business name
BAYBERRY NURSING HOME
Practice address
40 Keogh LN
New Rochelle, NY 10805-1308
Phone
(914) 636-6200
Fax
(914) 636-5125
NPI assigned
Jun 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Leonard Russ
Title
Administrator
Phone
(914) 636-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5904317N NY Primary

Addresses

Primary practice location

40 Keogh LN
New Rochelle, NY 10805-1308

Mailing address

40 Keogh LN
New Rochelle, NY 10805-1308
Phone (914) 636-6200

Other identifiers 1

IdentifierTypeStateIssuer
00420397MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111214000336 NY Part A Provider - Skilled Nursing Facility 1456526862 Practice locations: New Rochelle, NY

Skilled nursing facility certification: CCN 335614

Legal name
BAYBERRY NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1978
Last certification
May 30, 2023
Beds
60
Ownership / control type
Partnership
Organization structure
PartnershipProprietary
Incorporated
in NY
Enrollment address
40 Keogh LN
New Rochelle, NY 10805-1308
Nursing home name
BAYBERRY NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bayberry Nursing HomeCCN 335614 · 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 - Partnership
Certified
Jan 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6051.8 residents per day on average

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
33D2197421Bayberry Nursing Home40 Keogh Lane, New Rochelle, NY 10805Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Linda M Russ Individual General Partnership InterestPartner May 11, 2004 1%
Leonard Russ Individual 5% Or Greater Direct Ownership Interest Jul 1, 1994 99%
General Partnership InterestPrincipal Partner and Adminispar May 11, 2004 99%
Operational/Managerial ControlPrincipal Partner and Administra Apr 17, 1986 100%

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 1

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": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750387916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 KEOGH LN",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051308",
            "telephone_number": "914-636-6200",
            "fax_number": "914-636-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 KEOGH LN",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051308",
            "telephone_number": "914-636-6200",
            "fax_number": "914-636-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYBERRY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSS",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "914-636-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5904317N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00420397",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.