Organization Active NPI

University Nursing Home LLC

  • Skilled Nursing Facility
  • Bronx, NY
National Provider Identifier
1811005010
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
UNIVERSITY NURSING HOME LLC
Practice address
2505 Grand Ave
Bronx, NY 10468-4206
Phone
(718) 295-1400
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Kenneth Rozenberg
Title
Member
Phone
(718) 931-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2505 Grand Ave
Bronx, NY 10468-4206

Mailing address

4770 White Plains Rd
Bronx, NY 10470-1104
Phone (718) 931-9700

Other identifiers 1

IdentifierTypeStateIssuer
00312249MedicaidNY

Other names 1

  • University Center for Rehabilitation and Nursing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090615000063 NY Part A Provider - Skilled Nursing Facility 4880741222 Practice locations: Bronx, NY

Skilled nursing facility certification: CCN 335061001

Legal name
UNIVERSITY NURSING HOME LLC
Organization structure
LLCProprietary
Incorporated
Oct 15, 1999 in NY
Enrollment address
2505 Grand Ave
Bronx, NY 10468-4206
Nursing home name
UNIVERSITY CENTER FOR REHABILITATION AND NURSING
Affiliated entity
CENTERS HEALTH CARE

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0719791University Center for Rehabilitation and2505 Grand Ave, Bronx, NY 10468Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Avraham Areman Individual 5% Or Greater Direct Ownership InterestMember Oct 6, 2022 9%
David Schorr Individual W-2 Managing EmployeeLnha Sep 1, 2019
Elisabeth Farkas Individual 5% Or Greater Direct Ownership InterestMember Oct 6, 2022 9%
Kenneth Rozenberg Individual 5% Or Greater Direct Ownership InterestMember Oct 6, 2022 77%
Beth Rozenberg Individual 5% Or Greater Direct Ownership InterestMember Jan 1, 2009 5%

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1811005010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701104",
            "telephone_number": "718-931-9700",
            "fax_number": "718-829-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 GRAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104684206",
            "telephone_number": "718-295-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "ROZENBERG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-931-9700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312249",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Center for Rehabilitation and Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.