Organization Active NPI

Excelcare at Lewes LLC

  • Skilled Nursing Facility
  • Lewes, DE
National Provider Identifier
1891513131
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EXCELCARE AT LEWES LLC
Practice address
301 Ocean View Blvd
Lewes, DE 19958-1269
Phone
(302) 645-4664
NPI assigned
Sep 26, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Mr. Josh Raider
Title
Controller
Phone
(732) 380-5812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

301 Ocean View Blvd
Lewes, DE 19958-1269

Mailing address

1225 Carmel CT
Lakewood, NJ 08701-2209
Phone (732) 380-5812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250827002305 DE Part A Provider - Skilled Nursing Facility 2365943941 Practice locations: Lewes, DE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891513131. Details of each certification follow.

Skilled nursing facility certification: CCN 085034001

Legal name
EXCELCARE AT LEWES LLC
Organization structure
LLCProprietary
Enrollment address
301 Ocean View Blvd
Lewes, DE 19958-1269
Nursing home name
EXCELCARE AT LEWES LLC
Affiliated entity
EXCELCARE

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
JM and Mazel LLC Organization, Brooklyn, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 1, 2024 20%
Adp of the SNF Oct 1, 2024
Tonya Burton Individual Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Cheskel David Berkowitz Individual 5% Or Greater Indirect Ownership InterestOwner Oct 1, 2024 20%
Adp of the SNF Oct 1, 2024
Susan L Levy Individual Adp of the SNF Oct 1, 2024
Excelcare at Lewes Holdco LLC Organization, Lakewood, NJ Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2024 100%
Indigo de 3 LLC Organization, Newark, DE LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 1, 2024 60%
Adp of the SNF Oct 1, 2024
Martin Friedman Cpa PC Organization, Brooklyn, NY Corporation, LLC, For-profit Adp of the SNF Oct 1, 2024
Organization, Lakewood, NJ LLC, Holding company Adp of the SNF Oct 1, 2024
Kristen Shields Individual Adp of the SNF Jan 20, 2025
Oxford Finance LLC Organization, Alexandria, VA Financial institution, For-profit Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Organization, Lakewood, NJ LLC, Consulting firm, For-profit Adp of the SNF Oct 1, 2024
Revach LLC de-NJ Organization, Lakewood, NJ LLC, Consulting firm, For-profit Adp of the SNF Oct 1, 2024
Eliyahu Frankel Individual 5% Or Greater Indirect Ownership InterestCeo Oct 1, 2024 40%
Operational/Managerial Control Oct 1, 2024
Jennifer Vasquez Individual Adp of the SNF Oct 1, 2024
Joel Zupnick Individual Trustee of the SNF Oct 1, 2024
Mazel Family Trust Organization, Brooklyn, NY For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024
Adp of the SNF Oct 1, 2024
Organization, Newark, DE LLC Adp of the SNF Oct 1, 2024
Cibc Bank USA Organization, Chicago, IL Corporation, Financial institution Adp of the SNF Oct 1, 2024
Joel Leifer Individual 5% Or Greater Indirect Ownership InterestOwner Oct 1, 2024 20%
Adp of the SNF Oct 1, 2024
Organization, Lakewood, NJ LLC, For-profit Adp of the SNF Jan 27, 2026

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 5

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1891513131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CARMEL CT",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012209",
            "telephone_number": "732-380-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OCEAN VIEW BLVD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581269",
            "telephone_number": "302-645-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELCARE AT LEWES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "RAIDER",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "732-380-5812",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.