NPIMap

Organization Active NPI

Seminole Health Care LLC

Doing business as Seminole Care and Rehab Center

  • Skilled Nursing Facility
  • Seminole, OK
National Provider Identifier
1780921155
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SEMINOLE HEALTH CARE LLC
Doing business as
Seminole Care and Rehab Center
Practice address
1200 E Wrangler Blvd
Seminole, OK 74868-3512
Phone
(405) 382-1127
Fax
(405) 382-1129
NPI assigned
Jan 5, 2013
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Judah Bienstock
Title
Managing Member
Phone
(314) 812-2550

Specialties & licenses 1

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

Addresses

Primary practice location

1200 E Wrangler Blvd
Seminole, OK 74868-3512

Mailing address

1200 E Wrangler Blvd
Seminole, OK 74868-3512
Phone (405) 382-1127

Other names 1

  • Seminole Care and Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130909000167 OK Part A Provider - Skilled Nursing Facility 9133362395 Practice locations: Seminole, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780921155. Details of each certification follow.

Skilled nursing facility certification: CCN 375418

Legal name
SEMINOLE HEALTH CARE LLC
Doing business as
SEMINOLE CARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 29, 2002
Last certification
Sep 18, 2024
Beds
106
Ownership / control type
Corporation
Multi-facility organization
MGM Healthcare
Most recent change of ownership
Mar 15, 2013
Organization structure
LLCProprietary
Enrollment address
1200 E Wrangler Blvd
Seminole, OK 74868-3512
Nursing home name
SEMINOLE CARE AND REHABILITATION CENTER
Affiliated entity
MGM HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Seminole Care and Rehabilitation CenterCCN 375418 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 29, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10696.8 residents per day on average
Chain
MGM Healthcare27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1200 E Wrangler Blvd
Seminole, OK 74868
Phone (405) 382-1127

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Baruch Jeremias Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2019 63%
Phileshia Laxton Individual W-2 Managing EmployeeAdministrator Apr 16, 2017 100%
Oklahoma Acquisitions, LLC Organization, Lakewood, NJ LLC 5% Or Greater Direct Ownership Interest Dec 31, 2019 63%
Judah Bienstock Individual 5% Or Greater Direct Ownership Interest Dec 31, 2019 37%
Corporate OfficerManaging Member Mar 8, 2013 100%
Operational/Managerial ControlManaging Member Mar 1, 2013 100%

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 3

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": "1357344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1780921155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WRANGLER BLVD",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748683512",
            "telephone_number": "405-382-1127",
            "fax_number": "405-382-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WRANGLER BLVD",
            "city": "SEMINOLE",
            "state": "OK",
            "postal_code": "748683512",
            "telephone_number": "405-382-1127",
            "fax_number": "405-382-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-05",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "BIENSTOCK",
        "authorized_official_first_name": "JUDAH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "314-812-2550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seminole Care and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seminole, OK

Sources for this page

Verify at the official NPI Registry.