NPIMap

Organization Active NPI

33 Southmoor Properties, Inc.

  • Skilled Nursing Facility
  • Wheat Ridge, CO
National Provider Identifier
1902803620
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
020436 Issued in CO
Legal business name
33 SOUTHMOOR PROPERTIES, INC.
Practice address
2920 Fenton St
Wheat Ridge, CO 80214-8116
Phone
(303) 238-0481
Fax
(303) 233-3775
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Authorized official

Name
Mr. Jay H. Moskowitz, NHA
Title
Ceo
Phone
(303) 238-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 020436 CO Primary

Addresses

Primary practice location

2920 Fenton St
Wheat Ridge, CO 80214-8116

Mailing address

2920 Fenton St
Wheat Ridge, CO 80214-8116
Phone (303) 238-0481

Other identifiers 2

IdentifierTypeStateIssuer
4540660001OtherCODMERC NUMBER
80636217MedicaidCO

Other names 1

  • WHEATRIDGE MANOR NURSING HOME Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070622000227 TX Part A Provider - Skilled Nursing Facility 1850490467 Practice locations: Wheat Ridge, CO

Skilled nursing facility certification: CCN 065308

Legal name
33 SOUTHMOOR PROPERTIES, INC.
Doing business as
WHEATRIDGE MANOR CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1993
Last certification
Oct 19, 2023
Beds
65
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Vivage Beecan
Most recent change of ownership
Jul 1, 2024
Organization structure
CorporationProprietary
Incorporated
Dec 9, 1998 in CO
Enrollment address
2920 Fenton Street
Wheat Ridge, CO 80214-8116
Nursing home name
WHEATRIDGE CARE CENTER
Affiliated entity
VIVAGE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wheatridge Care CenterCCN 065308
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6554.0 residents per day on average
Chain
Vivage Senior Living6 facilities in the chain
Penalties (3 years)
2Fines totaling $20,616

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
33 Southmoor Properties Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
John D Brammeier Individual Corporate OfficerTreasurer, QP Health Care Servic Dec 31, 2011 18%
Mary E Koretke Individual Operational/Managerial Control Nov 20, 2014
Jay H Moskowitz Individual 5% Or Greater Direct Ownership Interest Dec 9, 1998 50%
Corporate OfficerCeo, QP Health Care Services Dec 31, 2011 82%
Quality Life Management, LLC Organization, Lakewood, CO LLC, Management services company, For-profit Operational/Managerial Control Apr 1, 1999 100%
QP Health Care Services LLC Organization, Lakewood, CO LLC, Management services company, For-profit Operational/Managerial Control Dec 31, 2011 100%

Facilities with the same owner 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1902803620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 FENTON ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "802148116",
            "telephone_number": "303-238-0481",
            "fax_number": "303-233-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 FENTON ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "802148116",
            "telephone_number": "303-238-0481",
            "fax_number": "303-233-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "33 SOUTHMOOR PROPERTIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "MOSKOWITZ",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-238-3838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC NUMBER",
            "identifier": "4540660001",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80636217",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WHEATRIDGE MANOR NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.