NPIMap

Organization Active NPI

Delmar Gardens of Omaha, LLC

Doing business as St. Joseph Villa Homecare & Hospice

  • Community Based Hospice Care Agency
  • Omaha, NE
National Provider Identifier
1790771301
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOSPICE24 Issued in NE
Legal business name
DELMAR GARDENS OF OMAHA, LLC
Doing business as
St. Joseph Villa Homecare & Hospice
Practice address
825 Dorcas St
Omaha, NE 68108
Phone
(402) 926-4444
Fax
(402) 393-8230
NPI assigned
Sep 20, 2005
Last updated
Dec 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Ken Marx
Title
Cfo
Phone
(636) 733-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOSPICE24 NE Primary

Addresses

Primary practice location

825 Dorcas St
Omaha, NE 68108

Mailing address

825 Dorcas St
Omaha, NE 68108
Phone (402) 926-4444

Other identifiers 1

IdentifierTypeStateIssuer
100251402-00MedicaidNE

Other names 1

  • St. Joseph Villa Homecare & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050329000891 NE Part A Provider - Hospice 7416901707 Practice locations: Omaha, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790771301. Details of each certification follow.

Hospice certification: CCN 281513

Legal name
DELMAR GARDENS OF OMAHA, LLC
Doing business as
ST. JOSEPH VILLA HOMECARE & HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 26, 1994
Last certification
Mar 29, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Mar 12, 2003 in NE
Enrollment address
825 Dorcas St
Omaha, NE 68108-1160

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
St. Joseph Villa Homecare & HospiceCCN 281513 · All quality measures
Ownership
For-Profit
Certified
Oct 26, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Delmar Gardens of Omaha LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3035 S 72nd St
Ste 200
Omaha, NE 68124
Phone (402) 926-4444

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Janice G Bitansky Individual OtherShareholder/Trustee Nov 30, 2010 4.26%
Harry Z Goldberg Individual OtherShareholder/Trustee Nov 30, 2010 4.26%
Non-Gstfamily Trust Est U/W Israel Goldberg Fbo Diane Fredman Organization, Chesterfield, MO 5% Or Greater Indirect Ownership Interest Apr 10, 2013 5.71%
Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara Organization, Chesterfield, MO 5% Or Greater Indirect Ownership Interest Mar 12, 2003 8.04%
Delmar Gardens Management Services Inc Organization, Chesterfield, MO Corporation, Management services company, For-profit Operational/Managerial Control Apr 1, 2005 100%
Delmar Gardens Enterprises Inc Organization, Chesterfield, MO Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 12, 2003 100%
Diane G Fredman Individual OtherShareholder/Trustee Nov 30, 2010 4.26%
Gabe Grossberg Individual 5% Or Greater Indirect Ownership Interest Mar 12, 2003 16.33%
Corporate OfficerPresident Mar 12, 2003
OtherTrustee Mar 12, 2003
Goldberg-Nom LLC Organization, Chesterfield, MO LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 12, 2003 25%
Maria Johnson Individual W-2 Managing EmployeeAdministrator May 3, 2022
George T Grossberg Individual 5% Or Greater Indirect Ownership Interest Mar 12, 2003 11.33%
OtherTrustee Mar 12, 2003
Non-GST Family Trust Est U/W of Israel Goldberg Fbo Janice Bitanski Organization, Chesterfield, MO 5% Or Greater Indirect Ownership Interest Apr 10, 2013 5.71%
Howard M Oppenheimer Individual Corporate OfficerVice-President and Secretary Mar 12, 2003
OtherTrustee Mar 12, 2003
Kenneth F Marx Individual Corporate OfficerChief Financial Officer Jun 11, 2019
George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara Organization, Chesterfield, MO 5% Or Greater Indirect Ownership Interest Mar 12, 2003 8.04%
Non-GST Family Trust Established U/W of Israel Goldberg Fbo Harry Zvi Organization, Chesterfield, MO 5% Or Greater Indirect Ownership Interest Apr 10, 2013 5.71%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 16

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

  • Delmar Gardens of Omaha, LLC

    dba St. Joseph Villa

    • Skilled Nursing Facility
    • Omaha, NE
    • NPI 1417942277

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Omaha, LLC

    dba St. Joseph Villa Homecare & Hospice

    • Home Health Agency
    • Omaha, NE
    • NPI 1760477525

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens Home Care, Inc.

    dba Delmar Gardens Home Care

    • Home Health Agency
    • Chesterfield, MO
    • NPI 1295720118

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens North Operating, LLC

    dba Delmar Gardens North

    • Skilled Nursing Facility
    • Black Jack, MO
    • NPI 1750376612

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Chesterfield Operating, LLC

    dba Delmar Gardens of Chesterfield

    • Skilled Nursing Facility
    • Chesterfield, MO
    • NPI 1861487712

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Creve Coeur Operating, LLC

    dba Delmar Gardens of Creve Coeur

    • Skilled Nursing Facility
    • Creve Coeur, MO
    • NPI 1265427124

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Gwinnett Operating, LLC

    dba Delmar Gardens of Gwinnett

    • Skilled Nursing Facility
    • Lawrenceville, GA
    • NPI 1255327862

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Lenexa Operating, LLC

    dba Delmar Gardens of Lenexa

    • Skilled Nursing Facility
    • Lenexa, KS
    • NPI 1336134295

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Meramec Valley Operating, LLC

    dba Delmar Gardens of Meramec Valley

    • Skilled Nursing Facility
    • Fenton, MO
    • NPI 1013903525

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of O'Fallon, LLC

    dba Delmar Gardens of O'Fallon

    • Skilled Nursing Facility
    • O'Fallon, MO
    • NPI 1942295803

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Overland Park Operating, LLC

    dba Delmar Gardens of Overland Park

    • Skilled Nursing Facility
    • Overland Park, KS
    • NPI 1285629048

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
  • Delmar Gardens of Smyrna, LLC

    dba Delmar Gardens of Smyrna

    • Skilled Nursing Facility
    • Smyrna, GA
    • NPI 1194711606

    Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

    CMS ownership
View all 16

Practitioners & affiliated clinicians

Practitioners 10

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 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": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1790771301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DORCAS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68108",
            "telephone_number": "402-926-4444",
            "fax_number": "402-393-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DORCAS ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68108",
            "telephone_number": "402-926-4444",
            "fax_number": "402-393-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELMAR GARDENS OF OMAHA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "636-733-7000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251402-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Villa Homecare & Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Joseph Villa Homecare & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.