NPIMap

Organization Active NPI

Complete Care at Brakeley Park LLC

  • Skilled Nursing Facility
  • Phillipsburg, NJ
National Provider Identifier
1902487820
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COMPLETE CARE AT BRAKELEY PARK LLC
Practice address
290 Red School LN
Phillipsburg, NJ 08865-2276
Phone
(610) 444-6350
NPI assigned
Apr 21, 2021
Last updated
May 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Authorized official

Name
Shalom Stein
Title
Authorized Signer
Phone
(732) 313-0880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

290 Red School LN
Phillipsburg, NJ 08865-2276

Mailing address

290 Red School LN
Phillipsburg, NJ 08865-2276
Phone (610) 444-6350

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 NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210915000293 NJ Part A Provider - Skilled Nursing Facility 4587060611 Practice locations: Phillipsburg, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902487820. Details of each certification follow.

Skilled nursing facility certification: CCN 315316

Legal name
COMPLETE CARE AT BRAKELEY PARK LLC
Doing business as
COMPLETE CARE AT BRAKELEY PARK LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 17, 1992
Last certification
Jan 5, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Complete Care
Organization structure
LLCProprietary
Incorporated
Jan 20, 2021 in DE
Enrollment address
290 Red School LN
Phillipsburg, NJ 08865-2276
Nursing home name
COMPLETE CARE AT BRAKELEY PARK
Affiliated entity
COMPLETE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Complete Care at Brakeley ParkCCN 315316 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 17, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120114.0 residents per day on average
Chain
Complete Care85 facilities in the chain
Penalties (3 years)
2Fines totaling $55,647

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Peace Capital Holdings LLC Organization, Howell, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2021 100%
Adp of the SNF Jul 1, 2021
Aurora Guardian II Realty, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
Aurora Guardian Partners II LLC Organization, New York, NY Corporation, LLC, For-profit Adp of the SNF Jul 1, 2021
Brakeley Park Realty, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
M Friedman 2018 Family Trust Organization, Brooklyn, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
Courtney Petocz Individual Operational/Managerial Control Jan 16, 2025
Adp of the SNF Jan 16, 2025
J & R Family Investments, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
SMS 2021 Trust Organization, Lakewood, NJ For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2021 95.1%
Adp of the SNF Jul 1, 2021
Donna Carducci Individual Operational/Managerial Control Jul 1, 2021
Adp of the SNF Jul 1, 2021
Aurora Guardian Holdco II Co-Borrower, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
R&J Family Investments LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
PC Wta Opco Holdco LLC Organization, Howell, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 1, 2021 100%
Etay Sahar Individual Operational/Managerial Control Mar 28, 2023
Managing Control - Governing Body Mar 28, 2023
Adp of the SNF Mar 28, 2023
Ana Gomes Individual Operational/Managerial Control Jul 1, 2021
Managing Control - Governing Body Jul 1, 2021
Adp of the SNF Jul 1, 2021
Hershel Schwartz Individual Operational/Managerial Control Jul 1, 2021
Adp of the SNF Jul 1, 2021
Aurora Guardian Holdco II Mezz Borrower, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
Landau Family Investment Trust Organization, New York, NY For-profit Adp of the SNF Jul 1, 2021
Aurora Guardian Holdco II, LLC Organization, New York, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
Welltower Inc Organization, Toledo, OH Corporation, Real estate investment trust (REIT) 5% Or Greater Security Interest Jul 1, 2021 34%
Adp of the SNF Jul 1, 2021
PC NJ1 Opcos LLC Organization, Howell, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2021 100%
Shalom Stein Individual Corporate Officer Jul 1, 2021
Managing Control - Governing Body Jul 1, 2021
Trustee of the SNF Jul 1, 2021
Indirect Ownership Interest Jul 1, 2021 4.9%
L Friedman Family Holdings LLC Organization, Brooklyn, NY LLC, Holding company, For-profit Adp of the SNF Jul 1, 2021
L Friedman 2018 Family Trust Organization, Brooklyn, NY For-profit Adp of the SNF Jul 1, 2021

Owners & managing parties with NPI records 1

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

  • Ana P Gomes, DO, CMD
    • Family Medicine Physician
    • Phillipsburg, NJ
    • NPI 1750348900

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 66

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

View all 66

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 4

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": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777593600000",
    "number": "1902487820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 RED SCHOOL LN",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652276",
            "telephone_number": "610-444-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 RED SCHOOL LN",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652276",
            "telephone_number": "610-444-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE AT BRAKELEY PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "732-313-0880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.