Hillside Manor Rehabilitation and Extended Care Center, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

HILLSIDE MANOR REHABILITATION AND EXTENDED CARE CENTER, LLC

Practice address

18811 Hillside Ave
Hollis, NY 11423-1935

Phone

(718) 291-3500

Fax

(718) 206-3790

NPI assigned

Sep 12, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Doug Wissmann

Title

Finance Director

Phone

(718) 291-8200

Specialties & licenses 1

Addresses

Other names 1

• Hillside Manor Certified Home Health Agency Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Jamaica Acquisition III LLC

  • Home Health Agency
  • Bronx, NY
  • NPI 1104337542

  Sold to, 2017-10-01

  CMS change of ownership

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1790186443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18215 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324853",
            "telephone_number": "718-291-8200",
            "fax_number": "718-291-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18811 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231935",
            "telephone_number": "718-291-3500",
            "fax_number": "718-206-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE MANOR REHABILITATION AND EXTENDED CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-12",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "WISSMANN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "718-291-8200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Manor Certified Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sima Hertzberg, PT
• Israel Yao Hiamaley, LPN
• Hillside Anesthesiology PC
• Hillside Family Dental PC
• Hillside Manor Rehabilitation and Extended Care Center, LLC
• Hillside Manor Rehabilitation and Extended Care Center, LLC
• Hillside Neurology Care,P.C.
• Hillside Open MRI PC
• Hillside Optimal Medical Care
• Hillside PC

• Home Health Agency in Hollis, NY
• Providers in Hollis, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.