NPIMap

Organization Active NPI

493 Black Oak Ridge Road, LLC

  • Skilled Nursing Facility
  • Wayne, NJ
National Provider Identifier
1861491540
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
493 BLACK OAK RIDGE ROAD, LLC
Practice address
493 Black Oak Ridge Road
Wayne, NJ 07470
Phone
(973) 692-9500
Fax
(973) 692-1992
NPI assigned
Jul 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Authorized official

Name
Mr. A. Alberto Lugo
Title
Executive VP & General Counsel
Phone
(201) 242-4000

Specialties & licenses 1

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

Addresses

Primary practice location

493 Black Oak Ridge Road
Wayne, NJ 07470

Mailing address

493 Black Oak Ridge Road
Wayne, NJ 07470
Phone (973) 692-9500

Other names 1

  • Care One at Wayne Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803000501 NJ Part A Provider - Skilled Nursing Facility 1658342712 Practice locations: Wayne, NJ

Skilled nursing facility certification: CCN 315477

Legal name
493 BLACK OAK RIDGE ROAD, LLC
Doing business as
CARE ONE AT WAYNE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jun 24, 2002
Last certification
Aug 29, 2024
Beds
101
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Mar 18, 2004 in NJ
Enrollment address
493 Black Oak Ridge Rd
Care One at Wayne
Wayne, NJ 07470-6501
Nursing home name
CAREONE AT WAYNE
Affiliated entity
CAREONE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Careone at WayneCCN 315477
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 24, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10197.3 residents per day on average
Chain
Careone37 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
493 Black Oak Ridge Road LLC2 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.

Locations

493 Black Oak Ridge Rd
Ste 1
Wayne, NJ 07470
Phone (973) 692-9500

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Healthbridge Management LLC Organization, Fort Lee, NJ For-profit Operational/Managerial Control Jul 25, 2008
Des 2009 GST Trust Organization, Fort Lee, NJ 5% Or Greater Indirect Ownership Interest Dec 1, 2021
David Baruch Individual Corporate Officer Dec 1, 2021
W-2 Managing Employee Dec 1, 2021
Care One LLC Organization, Fort Lee, NJ For-profit 5% Or Greater Direct Ownership Interest Mar 18, 2004
Des Holding Co., Inc. Organization, Fort Lee, NJ Holding company 5% Or Greater Indirect Ownership Interest Mar 18, 2004
Des-C 2009 Grat Organization, Fort Lee, NJ Non-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2009
Daniel E Straus Individual 5% Or Greater Indirect Ownership Interest Mar 18, 2004
Care One Management, LLC Organization, Fort Lee, NJ For-profit Operational/Managerial Control Mar 18, 2004

Facilities with the same owner 38

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

View all 38

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1861491540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 BLACK OAK RIDGE ROAD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-692-9500",
            "fax_number": "973-692-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 BLACK OAK RIDGE ROAD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-692-9500",
            "fax_number": "973-692-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "493 BLACK OAK RIDGE ROAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "LUGO",
        "authorized_official_first_name": "A.",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "EXECUTIVE VP & GENERAL COUNSEL",
        "authorized_official_telephone_number": "201-242-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Care One at Wayne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.