Jopal at St. James LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5157308N Issued in NY

Legal business name

JOPAL AT ST. JAMES LLC

Doing business as

Mills Pond Nursing and Rehabilitation Center

Practice address

273 Moriches Rd
Saint James, NY 11780-2117

Phone

(631) 862-8990

Fax

(631) 862-6792

NPI assigned

Oct 20, 2010

Last updated

Feb 7, 2014By 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

Pasquale Debenedictis

Title

Member

Phone

(631) 630-0314

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mills Pond Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1780994046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 MORICHES RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802117",
            "telephone_number": "631-862-8990",
            "fax_number": "631-862-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 MORICHES RD",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117802117",
            "telephone_number": "631-862-8990",
            "fax_number": "631-862-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOPAL AT ST. JAMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "DEBENEDICTIS",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "631-630-0314"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5157308N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mills Pond Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randall James, M.D.
• Jamie Ross, Licensed Marriage and Family Therapist, PLLC
• Donna Jarosak, RN
• JL Home Physical Therapy, PLLC
• Jennifer Ann Johnson, RN
• Salena B Joseph
• Dianne Jurlando, M.S.
• Hannah Allison Kaplan, BCBA, LBA
• Lori Ann Kenavan, FNP-C
• Elizabeth Kenny

• Skilled Nursing Facility in Saint James, NY
• Providers in Saint James, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.