NPIMap

Organization Active NPI

Princeton Manor Healthcare Center LLC

  • Skilled Nursing Facility
  • Oakland, CA
National Provider Identifier
1891146593
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRINCETON MANOR HEALTHCARE CENTER LLC
Practice address
2124 57TH Ave
Oakland, CA 94621-4322
Phone
(510) 261-2628
NPI assigned
Jun 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
David Silver
Title
Managing Member
Phone
(310) 896-7471

Specialties & licenses 1

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

Addresses

Primary practice location

2124 57TH Ave
Oakland, CA 94621-4322

Mailing address

2124 57TH Ave
Oakland, CA 94621-4322
Phone (510) 261-2628

Other identifiers 1

IdentifierTypeStateIssuer
ZZR05876IMedicaidCA

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 CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161006000787 CA Part A Provider - Skilled Nursing Facility 3779871751 Practice locations: Oakland, CA

Skilled nursing facility certification: CCN 055876

Legal name
PRINCETON MANOR HEALTHCARE CENTER LLC
Doing business as
ROCKPORT HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 18, 1968
Last certification
Jun 13, 2024
Beds
82
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jun 9, 2016 in CA
Enrollment address
2124 57TH Ave
Oakland, CA 94621-4322
Nursing home name
PRINCETON MANOR HEALTHCARE CENTER, LLC
Affiliated entity
CORPORATE INTERFACE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Princeton Manor Healthcare Center, LLCCCN 055876 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 18, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8280.0 residents per day on average
Chain
Corporate Interface Services40 facilities in the chain
Penalties (3 years)
1Fines totaling $0

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
05D0602911Princeton Manor2124 57TH Ave, Oakland, CA 94621Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Rockport Administrative Services, LLC Organization, Glendale, CA LLC Operational/Managerial Control Aug 1, 2016
Adp of the SNF Jun 4, 2025
Eretz Lion Creek Properties LLC Organization, Glendale, CA LLC Adp of the SNF Aug 1, 2016
Arun Manoharan Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Michelle L Silver Individual Direct Ownership Interest Jun 9, 2016 1%
David Samuel Silver Individual 5% Or Greater Direct Ownership InterestMember of LLC Jun 9, 2016 99%
Theartis Aldridge Individual Operational/Managerial Control Mar 16, 2025
Adp of the SNF Mar 16, 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 70

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

View all 70

Practitioners & affiliated clinicians

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": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1891146593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 57TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946214322",
            "telephone_number": "510-261-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 57TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946214322",
            "telephone_number": "510-261-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON MANOR HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "310-896-7471"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05876I",
            "state": "CA"
        }
    ],
    "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": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.