Friedwald Center for Rehabilitation and Nursing, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4350305N Issued in NY

Legal business name

FRIEDWALD CENTER FOR REHABILITATION AND NURSING, LLC

Practice address

475 New Hempstead Rd
New City, NY 10956-1000

Phone

(845) 678-2000

Fax

(845) 678-2090

NPI assigned

May 5, 2006

Last updated

Dec 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Steve Staum, LNHA

Title

Administrator

Phone

(845) 678-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831147214. Details of each certification follow.

• CCN 335734001 Skilled nursing facility · Details

Skilled nursing facility certification: CCN 335734001

Legal name

FRIEDWALD CENTER FOR REHABILITATION AND NURSING, LLC

Organization structure

LLCProprietary

Incorporated

Dec 19, 2003 in NY

Enrollment address

475 New Hempstead Rd
New City, NY 10956-1000

Nursing home name

FRIEDWALD CENTER FOR REHAB AND NURSING, L L C

Tax ID family

Friedwald Center for Rehabilitation and Nursing LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Friedwald Center Adult Day Health Center

  • Skilled Nursing Facility
  • New City, NY
  • NPI 1285892000
  NPD tax ID
• Friedwald Center for Rehab & Nursing Adhc

  • Adult Day Care Clinic/Center
  • New City, NY
  • NPI 1902084312
  NPD tax ID
• Friedwald Center for Rehabilitation & Nursing LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • New City, NY
  • NPI 1013334648
  NPD tax ID
• Friedwald Center for Rehabilitation and Nursing LLC

  • Skilled Nursing Facility
  • New City, NY
  • NPI 1225205057
  NPD tax ID

All disclosed owners & managing parties 13

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

Owners & managing parties with NPI records 3

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

• Michele Cohnen

  • Registered Dietitian
  • Thiells, NY
  • NPI 1851267769

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Lynn M Maxwell, OTR/L

  • Occupational Therapist
  • Goshen, NY
  • NPI 1861960916

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Dev Vikram Shah

  • Hospitalist Physician
  • Manhasset, NY
  • NPI 1235556325

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 4

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.

• Mohammad Hafeez, M. D.

  • Internal Medicine Physician
  • Suffern, NY
  • NPI 1639101595
  NPD (past)
• Dev Vikram Shah

  • Hospitalist Physician
  • Manhasset, NY
  • NPI 1235556325
  NPD (past)
• Vikram P Shah, MD

  • Internal Medicine Physician
  • Spring Valley, NY
  • NPI 1659411353
  NPD (past)
• Albert Harry Zucker, MD

  • Internal Medicine Physician
  • Monroe, NY
  • NPI 1740256239
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1831147214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NEW HEMPSTEAD RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109561000",
            "telephone_number": "845-678-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NEW HEMPSTEAD RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109561000",
            "telephone_number": "845-678-2000",
            "fax_number": "845-678-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEDWALD CENTER FOR REHABILITATION AND NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "STAUM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "845-678-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "4350305N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Friedwald Center Adult Day Health Center
• Friedwald Center for Dialysis LLC
• Friedwald Center for Rehab & Nursing Adhc
• Friedwald Center for Rehabilitation & Nursing LLC
• Friedwald Center for Rehabilitation and Nursing LLC
• Kimberly Friel
• Emily Mariel Fruman, LCSW
• Jack Fuentes
• Jacob Fuentes, DC
• Suzanne Gerdes Fultz, RDN

• Skilled Nursing Facility in New City, NY
• Providers in New City, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.