NPIMap

Organization Active NPI

Bridgeview Center, LLC

Doing business as Bridgeview Center

  • Skilled Nursing Facility
  • Ormond Beach, FL
National Provider Identifier
1821086091
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF10590961 Issued in FL
Legal business name
BRIDGEVIEW CENTER, LLC
Doing business as
Bridgeview Center
Practice address
350 S Ridgewood Ave
Ormond Beach, FL 32174-7028
Phone
(386) 677-4545
Fax
(386) 677-3445
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Mrs. Jennifer Alise Ziolkowski, MBA
Title
VP Finance
Phone
(813) 558-6629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF10590961 FL Primary

Addresses

Primary practice location

350 S Ridgewood Ave
Ormond Beach, FL 32174-7028

Mailing address

350 S Ridgewood Ave
Ormond Beach, FL 32174-7028
Phone (386) 677-4545

Other identifiers 4

IdentifierTypeStateIssuer
N98OtherFLBLUE CROSS BLUE SHIELD
026037100MedicaidFL
0007930518OtherFLAETNA
C105402OtherFLUNITED AMERICAN

Other names 1

  • Bridgeview Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030407000017 FL Part A Provider - Skilled Nursing Facility 4880503812 Practice locations: Ormond Beach, FL

Skilled nursing facility certification: CCN 105402

Legal name
BRIDGEVIEW CENTER LLC
Doing business as
BRIDGEVIEW CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1982
Last certification
Dec 5, 2024
Beds
139
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Aston Health
Most recent change of ownership
May 1, 2003
Organization structure
LLCProprietary
Incorporated
Dec 19, 2002 in FL
Enrollment address
350 S Ridgewood Ave
Ormond Beach, FL 32174-7028
Nursing home name
BRIDGEVIEW CENTER
Affiliated entity
ASTON HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bridgeview CenterCCN 105402 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
139115.5 residents per day on average
Chain
Aston Health38 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
10D1011497Bridgeview Center LLC350 S Ridgewood Dr, Ormond Beach, FL 32174Certificate of waiverApr 13, 2027

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Tricia Thacker Individual Corporate Officer Apr 5, 2022
Other Apr 5, 2022
Lce Partners LLC Organization, Brooklyn, NY Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Jan 1, 2021 100%
Samuel Klein Individual 5% Or Greater Indirect Ownership InterestManaging Member Jan 1, 2021 75%
Corporate OfficerOfficer Jan 1, 2021 75%
Kalisha Rose Boese Individual W-2 Managing EmployeeAdministrator Jan 19, 2023
Gabriel Living Center, LLC Organization, Tampa, FL Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Apr 1, 2003 100%
Samuel Gutman Individual 5% Or Greater Indirect Ownership InterestMember Jan 1, 2021 25%

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 2

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1821086091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S RIDGEWOOD AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747028",
            "telephone_number": "386-677-4545",
            "fax_number": "386-677-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S RIDGEWOOD AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321747028",
            "telephone_number": "386-677-4545",
            "fax_number": "386-677-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEVIEW CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "ZIOLKOWSKI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ALISE",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "813-558-6629",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF10590961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "N98",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026037100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007930518",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED AMERICAN",
            "identifier": "C105402",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeview Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.