NPIMap

Organization Active NPI

Modesto SNF Operations LLC

Doing business as Golden Modesto Care Center

  • Skilled Nursing Facility
  • Modesto, CA
National Provider Identifier
1821708173
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MODESTO SNF OPERATIONS LLC
Doing business as
Golden Modesto Care Center
Practice address
1900 Coffee Rd
Modesto, CA 95355-2703
Phone
(917) 251-2850
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Authorized official

Name
Shimon Spielman
Title
Cfo
Phone
(917) 251-2850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1900 Coffee Rd
Modesto, CA 95355-2703

Mailing address

1777 Avenue of the States Ste 102
Lakewood, NJ 08701-4779
Phone (917) 251-2850

Other names 1

  • Golden Modesto Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230720003751 CA Part A Provider - Skilled Nursing Facility 0840650933 Practice locations: Modesto, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821708173. Details of each certification follow.

Skilled nursing facility certification: CCN 056301

Legal name
MODESTO SNF OPERATIONS LLC
Doing business as
GOLDEN MODESTO CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1974
Last certification
Sep 19, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Sep 14, 2022 in CA
Enrollment address
1900 Coffee Rd
Modesto, CA 95355-2703
Nursing home name
GOLDEN MODESTO CARE CENTER
Affiliated entity
GOLDEN SNF OPERATIONS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Golden Modesto Care CenterCCN 056301 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120111.8 residents per day on average
Chain
Golden SNF Operations7 facilities in the chain
Penalties (3 years)
14Fines totaling $182,248

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Organization, Lakewood, NJ LLC, Owned by another organization or individual Indirect Ownership Interest Mar 1, 2023 3%
Joanne Souza Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Cafive SNF Consulting LLC Organization, Lakewood, NJ LLC, Management services company, Consulting firm Operational/Managerial Control Mar 1, 2023
Adp of the SNF Apr 9, 2025
Daniel C Meador Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Modesto SNF Operations LLC Organization, Modesto, CA LLC Operational/Managerial Control Mar 1, 2023
Adp of the SNF Apr 9, 2025
Ryan Matthew Dickerson Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Couve Healthcare Consulting LLC Organization, Vancouver, WA LLC, Management services company, Consulting firm Operational/Managerial Control Aug 31, 2023
Adp of the SNF Apr 9, 2025
Individual Indirect Ownership Interest Mar 1, 2023 2%
CH Cafive Holdings LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 1, 2023 60.5%
Adp of the SNF Mar 1, 2023
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Mar 1, 2023 2.25%
Individual Indirect Ownership Interest Mar 1, 2023 3%
Cafive Operations Holdings LLC Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2023 100%
Organization, Lakewood, NJ LLC, Holding company, Owned by another organization or individual Indirect Ownership Interest Mar 1, 2023 2.25%
Veritas Health Solutions LLC Organization, Lakewood, NJ LLC, Management services company Operational/Managerial Control Mar 1, 2023
Adp of the SNF Apr 9, 2025
Steven Earl Individual Operational/Managerial Control Mar 1, 2023
Managing Control - Governing BodyRegional VP of Operations Mar 1, 2023
Adp of the SNF Mar 1, 2023
Individual Indirect Ownership Interest Mar 1, 2023 2.25%
Yitzchok Yenowitz Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2023 30%
Corporate OfficerCeo Mar 1, 2023
Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Yisroel E Herzka Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2023 60.5%
Adp of the SNF Mar 1, 2023
Witzcorp LLC Organization, Lakewood, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 1, 2023 30%
Adp of the SNF Mar 1, 2023
Organization, Lakewood, NJ LLC, Owned by another organization or individual Indirect Ownership Interest Mar 1, 2023 2%
Karen Barias Individual Operational/Managerial Control Mar 1, 2023
Managing Control - Governing BodyRegional Director of Clinical Ops Mar 1, 2023
Adp of the SNF Mar 1, 2023
Individual Indirect Ownership Interest Mar 1, 2023 2.25%
Shimon Spielman Individual Corporate OfficerCfo Mar 1, 2023
Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Modesto SNF Realty LLC Organization, Modesto, CA LLC Adp of the SNF Apr 9, 2025
Cafive Opco Manager LLC Organization, Lakewood, NJ LLC, Management services company Operational/Managerial Control Mar 1, 2023
Adp of the SNF Apr 9, 2025

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 51

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

View all 51

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1821708173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 AVENUE OF THE STATES STE 102",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014779",
            "telephone_number": "917-251-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552703",
            "telephone_number": "917-251-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODESTO SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-25",
        "status": "A",
        "authorized_official_last_name": "SPIELMAN",
        "authorized_official_first_name": "SHIMON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "917-251-2850"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Modesto Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.