Organization Active NPI

Holmes Lake Operations LLC

  • Skilled Nursing Facility
  • Lincoln, NE
National Provider Identifier
1881436780
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HOLMES LAKE OPERATIONS LLC
Practice address
6101 Normal Blvd
Lincoln, NE 68506-2767
Phone
(402) 489-7175
NPI assigned
Jun 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Brian Gopin
Title
Cfo
Phone
(516) 504-9797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

6101 Normal Blvd
Lincoln, NE 68506-2767

Mailing address

945 N Central Ave
Woodmere, NY 11598-1604
Phone (516) 504-9797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240904001711 NE Part A Provider - Skilled Nursing Facility 5193265213 Practice locations: Lincoln, NE

Skilled nursing facility certification: CCN 285164

Legal name
HOLMES LAKE OPERATIONS LLC
Doing business as
HOLMES LAKE REHABILITATION & CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1995
Last certification
Oct 8, 2024
Beds
97
Ownership / control type
Corporation
Organization structure
LLCProprietary
Enrollment address
6101 Normal Blvd
Lincoln, NE 68506-2767
Nursing home name
HOLMES LAKE REHABILITATION & CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Holmes Lake Rehabilitation & Care CenterCCN 285164
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9756.2 residents per day on average

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
28D0714511Holmes Lake Operations LLC6101 Normal Blvd, Lincoln, NE 68506Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Holmes Lake Realty LLC Organization, Woodmere, NY LLC Adp of the SNF Aug 15, 2024
Yisroel I Chafetz Individual 5% Or Greater Indirect Ownership Interest Aug 15, 2024 99%
Operational/Managerial Control Aug 15, 2024
Adp of the SNF Aug 15, 2024
Jacque Moss Individual Operational/Managerial Control Aug 15, 2024
Aic Family Trust Organization, Valley Stream, NY Adp of the SNF Aug 15, 2024
Yehudah Jay Walden Individual Trustee of the SNF Aug 15, 2024
Adina Reisman Individual Trustee of the SNF Aug 15, 2024
Holmes Lake Opco Holdings LLC Organization, Woodmere, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 15, 2024 100%
JRW Family Holdings LLC Organization, Valley Stream, NY LLC, Holding company Adp of the SNF Aug 15, 2024
Reisman Family Trust Organization, Valley Stream, NY Adp of the SNF Aug 15, 2024
Aic65 Family Holdings LLC Organization, Valley Stream, NY LLC, Holding company Adp of the SNF Aug 15, 2024
Rochel Walden Family Trust Organization, Valley Stream, NY Adp of the SNF Aug 15, 2024
Arif a Sattar Individual Operational/Managerial Control Aug 15, 2024
VNB New York LLC Organization, Wayne, NJ LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Aug 15, 2024 75%
Ehc Holmes Lake Realty Holdings LLC Organization, Woodmere, NY LLC, Holding company Adp of the SNF Aug 15, 2024
Jacob I Walden Family Trust Organization, Valley Stream, NY Adp of the SNF Aug 15, 2024

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 2

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": "1718064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1881436780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 N CENTRAL AVE",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981604",
            "telephone_number": "516-504-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 NORMAL BLVD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062767",
            "telephone_number": "402-489-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMES LAKE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "GOPIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-504-9797"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.