Organization Active NPI

New Glen Oaks Nursing Home Inc.

  • Skilled Nursing Facility
  • Glen Oaks, NY
National Provider Identifier
1871604009
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7003391N Issued in NY
Legal business name
NEW GLEN OAKS NURSING HOME INC.
Practice address
26001 79TH Ave
Glen Oaks, NY 11004-1312
Phone
(718) 343-0770
Fax
(718) 343-0773
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Mr. Abe Greenbaum
Title
President
Phone
(718) 343-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7003391N NY Primary

Addresses

Primary practice location

26001 79TH Ave
Glen Oaks, NY 11004-1312

Mailing address

26001 79TH Ave
Glen Oaks, NY 11004-1312
Phone (718) 343-0770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111208000708 NY Part A Provider - Skilled Nursing Facility 3779758321 Practice locations: Glen Oaks, NY

Skilled nursing facility certification: CCN 335299

Legal name
NEW GLEN OAKS NURSING HOME INC.
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1970
Last certification
Jun 10, 2024
Beds
60
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 20, 1995 in NY
Enrollment address
260-01 79TH Ave
Glen Oaks, NY 11004-1312
Nursing home name
NEW GLEN OAKS NURSING HOME, INC

Care Compare: Nursing home

Medicare Care Compare
Listed as
New Glen Oaks Nursing Home, IncCCN 335299
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6059.5 residents per day on average
Penalties (3 years)
5Fines totaling $23,443

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
33D0859361New Glen Oaks Nursing Home Inc260-01 79TH Ave, Glen Oaks, NY 11004Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Abe Greenbaum Individual 5% Or Greater Direct Ownership InterestPresident Dec 20, 1995 100%
Corporate OfficerPresident Dec 20, 1995 100%
Corporate Director Dec 20, 1995 100%
Operational/Managerial Control Dec 20, 1995
Managing Control - Governing BodyPresident Dec 20, 1995
Emil Fuzaylov Individual Operational/Managerial Control Mar 6, 2023
Adp of the SNF Mar 6, 2023
Janaki Kanumilli Individual Operational/Managerial Control Aug 22, 2016
Adp of the SNF Jul 22, 2016

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1871604009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26001 79TH AVE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041312",
            "telephone_number": "718-343-0770",
            "fax_number": "718-343-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 79TH AVE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041312",
            "telephone_number": "718-343-0770",
            "fax_number": "718-343-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW GLEN OAKS NURSING HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "ABE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-343-0770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7003391N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.