Bridgepark Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BRIDGEPARK OPERATIONS, LLC

Doing business as

Autumn Lake Healthcare at Bridgepark

Practice address

4017 Liberty Heights Ave
Baltimore, MD 21207-7545

Phone

(877) 567-0402

Fax

(718) 567-0600

NPI assigned

Apr 10, 2018

Organization subpart

No

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

Addresses

Other names 1

• Autumn Lake Healthcare at Bridgepark Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Skilled nursing facility certification: CCN 215195

Legal name

BRIDGEPARK OPERATIONS, LLC

Doing business as

AUTUMN LAKE HEALTHCARE AT BRIDGEPARK

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1989

Last certification

Nov 10, 2021

Beds

106

Ownership / control type

Corporation

Multi-facility organization

Autumn Lake

Organization structure

LLCProprietary

Incorporated

Feb 12, 2018 in NJ

Enrollment address

4017 Liberty Heights Ave
Baltimore, MD 21207-7545

Nursing home name

AUTUMN LAKE HEALTHCARE AT BRIDGEPARK

Affiliated entity

AUTUMN LAKE HEALTHCARE

Listed as

Autumn Lake Healthcare at BridgeparkCCN 215195 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10687.4 residents per day on average

Chain

Autumn Lake Healthcare59 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Autumn Lake Healthcare at Bridgepark2 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.

• Bridgepark Operations, LLC

  dba Autumn Lake Healthcare at Bridgepark

  • Skilled Nursing Facility
  • Baltimore, MD
  • NPI 1154896694
  NPD tax ID

All disclosed owners & managing parties 10

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 2

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

• Narender Pal Singh Bharaj, M.D.

  • Internal Medicine Physician
  • Parkville, MD
  • NPI 1083682074

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Bezalel Stern

  • Physical Therapist
  • Monsey, NY
  • NPI 1073783544

  5% Or Greater Direct Ownership Interest, Adp of the SNF

  CMS ownership

Practitioners 4

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

• Anwar I Khokhar, MD PA

  • Specialist
  • Baltimore, MD
  • NPI 1407822927
  NPD (past)
• Dorothy M Seay, M.D.

  • Internal Medicine Physician
  • Linthicum Heights, MD
  • NPI 1255376539
  NPD (past)
• Fei Zhao, M.D.

  • Internal Medicine Physician
  • Parkville, MD
  • NPI 1073036562
  NPD (past)
• Patience Agbonavbare, M.D.

  • Internal Medicine Physician
  • Tappahannock, VA
  • NPI 1952651309
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Anwar I Khokhar, MD PA

  • Specialist
  • Baltimore, MD
  • NPI 1407822927

  Nursing home

  Care Compare affiliation
• Fei Zhao, M.D.

  • Internal Medicine Physician
  • Parkville, MD
  • NPI 1073036562

  Nursing home

  Care Compare affiliation
• Patience Agbonavbare, M.D.

  • Internal Medicine Physician
  • Tappahannock, VA
  • NPI 1952651309

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1831696509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "718-567-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 LIBERTY HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077545",
            "telephone_number": "877-567-0402",
            "fax_number": "718-567-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPARK OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-05-04",
        "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 Bridgepark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sanaai Bridgeford
• Erika Bridgeforth
• Taylor Bridgeforth
• Anna Elizabeth Bridgeman
• Bridgepark Operations, LLC (Autumn Lake Healthcare at Bridgepark)
• Cheryl Dianna Bridges, DNP, MS, MBA, ACNP
• Dana Denise Bridges, MS, CRNP-BC
• Marie Therese Bridges, MS, RDN, CEDS
• Savana Bridges
• Bridgeway Consulting

• Skilled Nursing Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.