Active NPI
13TH Road Opco LLC
Doing business as Aviata at Greenacres
- Skilled Nursing Facility
- Greenacres, FL
National Provider Identifier
1902585177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- 13TH ROAD OPCO LLC
- Doing business as
- Aviata at Greenacres
- Practice address
- 6414 13TH Rd S
Greenacres, FL 33415-1401 - Phone
- (561) 478-9900
- Fax
- (561) 478-5067
- NPI assigned
- Jul 14, 2023
- Last updated
- Apr 9, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nathan Freund
- Title
- Manager
- Phone
- (732) 730-7480
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
6414 13TH Rd S
Greenacres, FL 33415-1401
Mailing address
6414 13TH Rd S
Greenacres, FL 33415-1401
Phone (561) 478-9900
Other names 1
- Aviata at Greenacres
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | Consulate Health Care |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240118003751 | FL | Part A Provider - Skilled Nursing Facility | 6608228267 | Practice locations: Greenacres, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1902585177. Details of each certification follow.
Skilled nursing facility certification: CCN 105611
- Legal name
- 13TH ROAD OPCO LLC
- Doing business as
- AVIATA AT GREENACRES
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 11, 1988
- Last certification
- Mar 14, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Jul 3, 2023 in FL
- Enrollment address
- 6414 13TH Rd S
Greenacres, FL 33415-1401 - Nursing home name
- AVIATA AT GREENACRES
- Affiliated entity
- AVIATA HEALTH GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Aviata at Greenacres
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 11, 1988
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Aviata Health Group
- Penalties (3 years)
- 4
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0878921 | Aviata at Greenacres | Certificate of waiver | Nov 8, 2027 |
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- HealthSun Health Plans Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| 13TH Road Parent LLC | 5% Or Greater Direct Ownership Interest | Sep 1, 2023 | 100% |
| David O Kateb | Operational/Managerial Control | Mar 6, 2025 | |
| Adp of the SNF | Mar 6, 2025 | ||
| Aspire MGT LLC | Adp of the SNF | Sep 1, 2023 | |
| Adp of the SNF | Jul 20, 2025 | ||
| Adp of the SNF | Jun 23, 2025 | ||
| Nochum Freund | Corporate Officer | Sep 1, 2023 | |
| Operational/Managerial Control | Sep 1, 2023 | ||
| Andres Bohorquez | Operational/Managerial Control | Oct 30, 2023 | |
| Adp of the SNF | Oct 30, 2023 | ||
| Wood Lake Holdco LLC | 5% Or Greater Indirect Ownership Interest | Sep 1, 2023 | 100% |
| Adp of the SNF | Jul 20, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Pulmonary Disease Physician
- Delray Beach, FL
- NPI 1679677611
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 3
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": "1689292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1744156800000",
"number": "1902585177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6414 13TH RD S",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334151401",
"telephone_number": "561-478-9900",
"fax_number": "561-478-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6414 13TH RD S",
"city": "GREENACRES",
"state": "FL",
"postal_code": "334151401",
"telephone_number": "561-478-9900",
"fax_number": "561-478-5067"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "13TH ROAD OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-14",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A",
"authorized_official_last_name": "FREUND",
"authorized_official_first_name": "NATHAN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "732-730-7480"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "Y",
"endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
"affiliationName": "Consulate Health Care",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "850 Concourse Pkwy S Ste 250",
"city": "Maitland",
"state": "FL",
"country_code": "US",
"postal_code": "327516155",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Aviata at Greenacres",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greenacres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.