NPIMap

Organization Active NPI

Bay at Oconto Health and Rehabilitation Center LLC

Doing business as Oconto Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Oconto, WI
National Provider Identifier
1902460348
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BAY AT OCONTO HEALTH AND REHABILITATION CENTER LLC
Doing business as
Oconto Health and Rehabilitation Center
Practice address
101 1St St
Oconto, WI 54153-1117
Phone
(516) 605-9800
NPI assigned
Apr 30, 2019
Last updated
Sep 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Authorized official

Name
Mr. Menachem Ruvel
Title
Managing Member
Phone
(516) 605-9800

Specialties & licenses 1

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

Addresses

Primary practice location

101 1St St
Oconto, WI 54153-1117

Mailing address

165 N Village Ave
Rockville Centre, NY 11570-3761
Phone (516) 605-9800

Other identifiers 1

IdentifierTypeStateIssuer
41536700MedicaidWI

Other names 1

  • Oconto Health and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark@championhcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190522001147 WI Part A Provider - Skilled Nursing Facility 5890038442 Practice locations: Oconto, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902460348. Details of each certification follow.

Skilled nursing facility certification: CCN 525670

Legal name
BAY AT OCONTO HEALTH AND REHABILITATION CENTER LLC
Doing business as
OCONTO HEALTH AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 16, 2003
Last certification
Jul 3, 2024
Beds
50
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jun 1, 2019 in WI
Enrollment address
101 1St St
Oconto, WI 54153-1117
Nursing home name
OCONTO HEALTH AND REHAB CENTER
Affiliated entity
CHAMPION CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oconto Health and Rehab CenterCCN 525670 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 16, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5040.7 residents per day on average
Chain
Champion Care22 facilities in the chain
Penalties (3 years)
2Fines totaling $18,819

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
52D0691411Bay at Oconto, the101 First St, Oconto, WI 54153Certificate of waiverJan 29, 2028

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
Champion Care LLC Organization, Rockville Ctr, NY LLC Operational/Managerial Control Jun 1, 2019 100%
Menachem Ruvel Individual 5% Or Greater Direct Ownership InterestOwner Jun 1, 2019 47.55%
Operational/Managerial ControlManaging Partner Jun 1, 2019 47.55%
Yisroel N Weinberg Individual 5% Or Greater Direct Ownership InterestOwner Jun 1, 2019 47.55%
Operational/Managerial ControlManaging Partner Jun 1, 2019 47.55%

Facilities with the same owner 10

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

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": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694131200000",
    "number": "1902460348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703761",
            "telephone_number": "516-605-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 1ST ST",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541531117",
            "telephone_number": "516-605-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AT OCONTO HEALTH AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A",
        "authorized_official_last_name": "RUVEL",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "516-605-9800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41536700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark@championhcare.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "101 1st St",
            "city": "Oconto",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541531117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Oconto Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oconto, WI

Sources for this page

Verify at the official NPI Registry.