Lansing Opco, LLC
Organization Active NPI Skilled Nursing Facility · Lansing, MI
NPI 1821495045 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1821495045
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- LANSING OPCO, LLC
- Practice address
- 731 Starkweather Dr
Lansing, MI 48917-1128 - Phone
- (517) 323-9133
- Fax
- (517) 323-0092
- NPI assigned
- Dec 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Mr. Stacey Paul Rogers
- Title
- Chief Financial Officer
- Phone
- (502) 429-0650
Facilities with the same owner 77
Practitioners 3
-
Francesca Marie Buskulic, D.O.
-
Shirin Elizabeth Doshi, D.O.
-
Phillip S Eisenberg, D.O.
Affiliated clinicians 2
-
Shirin Elizabeth Doshi, D.O.
-
Phillip S Eisenberg, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Medilodge of Lansing
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 1, 1976
- Medicare certification status
- Active
- Certified beds
- 85 · 74.1 residents per day on average
- Chain
- Medilodge
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0669319 | Lansing Opco, LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Skilled nursing facility certification: CCN 235285
- Legal name
- LANSING OPCO LLC
- Doing business as
- MEDILODGE OF LANSING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1976
- Last certification
- Oct 3, 2024
- Beds
- 85
- Ownership / control type
- Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 14, 2014 in DE
- Enrollment address
- 731 Starkweather Dr
Lansing, MI 48917-1128 - Nursing home name
- MEDILODGE OF LANSING
- Affiliated entity
- MEDILODGE
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Ark Opco Group, LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2015 | 100% |
| Cody Healthcare S Corp |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 47.55% |
| B&Y Trust |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 47.55% |
| Prestige Administrative Services, LLC |
Operational/Managerial Control | Jan 1, 2016 | |
| Craig a Flashner |
Corporate Director |
Jul 2, 2015 | |
| Operational/Managerial Control |
Jul 2, 2015 | ||
| Kristine Ranel Kirk |
W-2 Managing Employee |
Sep 2, 2016 | |
| Robert L Norcross |
Contracted Managing Employee |
Jul 2, 2015 | |
| Craig Flashner 2007 Trust |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 47.55% |
| B&Y Healthcare S Corp |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 47.55% |
| Stacey Paul Rogers |
Contracted Managing Employee |
Jul 1, 2015 | |
| Noble Healthcare Management, LLC |
Operational/Managerial Control | Jul 1, 2015 | |
| Yitzchok a Perlstein |
Corporate Director |
Jul 2, 2015 | |
| Operational/Managerial Control |
Jul 2, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150811005768 | MI | Part a Provider - Skilled Nursing Facility | 1658686274 | Practice locations: Lansing, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
731 Starkweather Dr
Lansing, MI 48917-1128
Mailing address
7400 New la Grange Rd Ste 400
Louisville, KY 40222-4870
Phone (502) 429-8062
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821495045 | Medicaid | MI |
Other names
- Medilodge of Lansing
Other providers in Lansing, MI
- Lansing Mdvip
- Lansing Medical P.L.L.C
- Lansing Medical P.L.L.C
- Lansing Medical Supplies
- Lansing Mercy Ambulance Service, Inc.
- Lansing Ophthalmology, PC
- Lansing Orthopedic PC
- Lansing Pain and Rehab PLLC
- Lansing Pain and Rehabilitation PLLC
- Lansing Pediatric Associates, P.C.
All providers in Lansing, MI · Skilled Nursing Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.