Montgomery Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MONTGOMERY OPERATOR LLC

Doing business as

Montgomery Village Care Center

Practice address

19301 Watkins Mill Rd
Montgomery Village, MD 20886-6914

Phone

(301) 527-2500

Fax

(301) 527-2525

NPI assigned

Feb 10, 2022

Last updated

Feb 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 3

Addresses

Other names 1

• Montgomery Village Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780338483. Details of each certification follow.

• CCN 215272 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 215272

Legal name

MONTGOMERY OPERATOR LLC

Doing business as

MONTGOMERY VILLAGE CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 14, 1995

Last certification

Jan 28, 2021

Beds

147

Ownership / control type

Corporation

Most recent change of ownership

Mar 1, 2022

Organization structure

LLCProprietary

Incorporated

Dec 15, 2021 in DE

Enrollment address

19301 Watkins Mill Rd
Montgomery Village, MD 20886-6914

Nursing home name

MONTGOMERY VILLAGE CARE CENTER

Listed as

Montgomery Village Care CenterCCN 215272 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 14, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

147161.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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, and the practitioner matching its NPPES authorized official.

• Vinu Ganti, MD

  • Internal Medicine Physician
  • Germantown, MD
  • NPI 1760499826
  NPD (past)
• Fisehatsion G Mehari, MD

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1023052867
  NPD (past)

Affiliated clinicians 2

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

• Vinu Ganti, MD

  • Internal Medicine Physician
  • Germantown, MD
  • NPI 1760499826

  Nursing home

  Care Compare affiliation
• Priya Vasdev, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Bowie, MD
  • NPI 1942221197

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1780338483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19301 WATKINS MILL RD",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208866914",
            "telephone_number": "301-527-2500",
            "fax_number": "301-527-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery Village Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald Miengue
• Almaz Tekie Misgina
• Jacqueline Nabel Monteiro
• Montgomery County Maryland Government
• Montgomery County Maryland Government
• Montgomery Physician Associates PC
• Montgomery Village Pain and Rehabilitation Center LLC
• Karla Montoya
• Tyasia Chanteniya Moulton
• Amrita Mukherjee, D.O.

• Skilled Nursing Facility in Montgomery Village, MD
• Providers in Montgomery Village, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.