NPIMap

Organization Active NPI

Pikesville Operator, LLC

Doing business as Autumn Lake Healthcare at Pikesville

  • Skilled Nursing Facility
  • Pikesville, MD
National Provider Identifier
1811489511
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PIKESVILLE OPERATOR, LLC
Doing business as
Autumn Lake Healthcare at Pikesville
Practice address
7 Sudbrook LN
Pikesville, MD 21208-4118
Phone
(410) 486-8771
NPI assigned
May 30, 2018
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(718) 567-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MD Primary
Respite Care 385H00000X MD

Addresses

Primary practice location

7 Sudbrook LN
Pikesville, MD 21208-4118

Mailing address

14C 53Rd St
Brooklyn, NY 11232-2644

Other names 1

  • Autumn Lake Healthcare at Pikesville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180913000704 MD Part A Provider - Skilled Nursing Facility 4385993468 Practice locations: Pikesville, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811489511. Details of each certification follow.

Skilled nursing facility certification: CCN 215082

Legal name
PIKESVILLE OPERATOR, LLC
Doing business as
AUTUMN LAKE HEALTHCARE AT PIKESVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 29, 1976
Last certification
Aug 11, 2022
Beds
140
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
May 10, 2018 in NJ
Enrollment address
7 Sudbrook LN
Pikesville, MD 21208-4118
Nursing home name
AUTUMN LAKE HEALTHCARE AT PIKESVILLE
Affiliated entity
AUTUMN LAKE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Autumn Lake Healthcare at PikesvilleCCN 215082 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 29, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
140117.2 residents per day on average
Chain
Autumn Lake Healthcare59 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Autumn Lake Healthcare at Pikesville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Brand Sonnenschine LLP Organization, Brooklyn, NY Adp of the SNF Aug 1, 2018
King David Equities LLC Organization, Brooklyn, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 11.74%
Adp of the SNF Aug 1, 2018
Accurate Staffing LLC Organization, Brooklyn, NY LLC, Medical staffing company Adp of the SNF Aug 1, 2018
4260 Group LLC Organization, Howell, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 16.9%
Adp of the SNF Aug 1, 2018
Aryeh Stern Individual 5% Or Greater Direct Ownership InterestOwner Aug 1, 2018 60.81%
Adp of the SNF Aug 1, 2018
Andres Eduardo Salazar Individual Operational/Managerial Control Aug 1, 2018
Adp of the SNF Aug 1, 2018
The Markstein Group LLC Organization, Howell, NJ LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 5.51%
Adp of the SNF Aug 1, 2018
Pikesville Realty LLC Organization, Howell, NJ LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Aug 1, 2018 100%
Adp of the SNF Aug 1, 2018
Mark Schwartz Individual Corporate OfficerCoo Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Ahron Eisenreich Individual Operational/Managerial Control Jan 16, 2019
Adp of the SNF Jan 16, 2019
Morris Meisels Individual 5% Or Greater Direct Ownership Interest Aug 1, 2018 5.04%
Adp of the SNF Aug 1, 2018

Owners & managing parties with NPI records 1

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

  • Andres Salazar
    • Geriatric Medicine (Family Medicine) Physician
    • Ellicott City, MD
    • NPI 1265594493

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

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

  • King David at Autumn Lake LLC

    dba King David Nursing and Rehabilitation Center

    • Skilled Nursing Facility
    • Baltimore, MD
    • NPI 1437693785

    4260 Group LLC, King David Equities LLC, The Markstein Group LLC

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 6

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 5

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": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1811489511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SUDBROOK LN",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212084118",
            "telephone_number": "410-486-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKESVILLE OPERATOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-567-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare at Pikesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

Verify at the official NPI Registry.