NPIMap

Organization Active NPI

Blueberry Hill Operator LLC

  • Skilled Nursing Facility
  • Beverly, MA
National Provider Identifier
1861817306
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BLUEBERRY HILL OPERATOR LLC
Practice address
75 Brimbal Ave
Beverly, MA 01915-6009
Phone
(978) 927-2020
Fax
(732) 608-2976
NPI assigned
Feb 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Yitzchok Rokowsky
Title
Manager
Phone
(732) 415-6016

Specialties & licenses 1

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

Addresses

Primary practice location

75 Brimbal Ave
Beverly, MA 01915-6009

Mailing address

575 Route 70
2ND Floor
Brick, NJ 08723-4042
Phone (732) 606-5973

Other names 1

  • Blueberry Hill Rehabilitation and Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411000215 MA Part A Provider - Skilled Nursing Facility 4688806367 Practice locations: Beverly, MA

Skilled nursing facility certification: CCN 225133

Legal name
BLUEBERRY HILL OPERATOR LLC
Doing business as
BLUEBERRY HILL REHABILITATION AND HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 30, 1967
Last certification
Nov 12, 2024
Beds
132
Ownership / control type
Corporation
Multi-facility organization
Marquis Health Services
Organization structure
LLCProprietary
Incorporated
Feb 10, 2014 in DE
Enrollment address
75 Brimbal Ave
Beverly, MA 01915-6009
Nursing home name
BLUEBERRY HILL REHABILITATION AND HEALTHCARE CTR
Affiliated entity
MARQUIS HEALTH SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Blueberry Hill Rehabilitation and Healthcare CtrCCN 225133
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 30, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
132121.8 residents per day on average
Chain
Marquis Health Services87 facilities in the chain
Penalties (3 years)
3Fines totaling $231,459

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0685889Blueberry Hill Operator, LLC75 Brimbal Avenue, Beverly, MA 01915Certificate of waiverMay 16, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Jacinta Smith Individual Managing Control - Governing BodyMember of Governing Body May 1, 2025
Adp of the SNF Sep 28, 2023
Organization, New Canaan, CT LLC, Consulting firm, For-profit Adp of the SNF Mar 18, 2025
Organization, Beverly, MA LLC, For-profit Adp of the SNF Jun 1, 2014
Janarthanan Someswarananthan Individual Operational/Managerial Control Feb 7, 2018
Adp of the SNF Feb 7, 2018
Quinto Guardian LLC Organization, Brick, NJ LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Jun 1, 2014 90%
Reliant Pro Rehab LLC Organization, Plano, TX LLC, Medical provider/supplier, For-profit Operational/Managerial Control Dec 1, 2017
Adp of the SNF Mar 18, 2025
Ukr Consulting LLC Organization, Brick, NJ LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Jun 1, 2014 10%
Organization, Brick, NJ LLC, Consulting firm, For-profit Adp of the SNF Mar 18, 2025
Yr 2013 Investment Trust U/a/D 3/25/13 Organization, Brick, NJ Indirect Ownership Interest Jun 1, 2014 22.5%
Organization, Louisville, KY LLC, Consulting firm, For-profit Adp of the SNF Mar 18, 2025
Marquis Limited LLC Organization, Brick, NJ LLC, For-profit Operational/Managerial Control Jan 1, 2021
Adp of the SNF Mar 18, 2025
Tryko Guardian Holdings LLC Organization, Brick, NJ LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Jun 1, 2014 67.5%
Mindee Posen Individual Operational/Managerial Control Jan 1, 2022
Adp of the SNF Jun 1, 2014
Mark R Nugent Individual Operational/Managerial Control Mar 18, 2026
Managing Control - Governing BodyMember of Governing Body Mar 18, 2026
Adp of the SNF Mar 18, 2026
Kohn Fam TR GST Exempt Uad 3-25-13 Organization, Chicago, IL Indirect Ownership Interest Dec 31, 2021 22.5%
Rsbrmk Holdings LLC Organization, Brick, NJ For-profit, Owned by another organization or individual Indirect Ownership Interest Jan 1, 2022 22.5%
Organization, Manalapan, NJ LLC, Consulting firm, For-profit Adp of the SNF Jun 3, 2026
NFR 2020 Irrv TR Organization, Brick, NJ Indirect Ownership Interest Jan 1, 2022 22.5%
Organization, Brick, NJ LLC, Consulting firm, For-profit Adp of the SNF Mar 18, 2025
Cibc Bank USA Organization, Chicago, IL Corporation, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Jun 2, 2014 75%
SK 2013 Investment TR Ua 03252013 Organization, Brick, NJ Indirect Ownership Interest Jan 1, 2022 22.5%
Uak 2020 Irrv TR Organization, Lakewood, NJ Indirect Ownership Interest Jan 1, 2022 9.9%
Jeffrey Crowley Individual Managing Control - Governing BodyMember of Governing Body May 1, 2025
Adp of the SNF Sep 30, 2024
Organization, Brick, NJ LLC, Consulting firm, For-profit Adp of the SNF Mar 18, 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 80

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

View all 80

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 3

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": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1861817306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROUTE 70",
            "address_2": "2ND FLOOR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234042",
            "telephone_number": "732-606-5973",
            "fax_number": "732-608-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BRIMBAL AVE",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156009",
            "telephone_number": "978-927-2020",
            "fax_number": "732-608-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBERRY HILL OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "ROKOWSKY",
        "authorized_official_first_name": "YITZCHOK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-415-6016"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Blueberry Hill Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.