NPIMap

Organization Active NPI

Solaris Healthcare Windermere LLC

  • Skilled Nursing Facility
  • Orlando, FL
National Provider Identifier
1912378514
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOLARIS HEALTHCARE WINDERMERE LLC
Practice address
4875 Cason Cove Dr
Orlando, FL 32811-6302
Phone
(407) 420-2090
NPI assigned
Oct 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Bobby Pate
Title
Manager
Phone
(407) 420-2090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4875 Cason Cove Dr
Orlando, FL 32811-6302

Mailing address

PO Box 3310
Windermere, FL 34786-3310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222002839 FL Part A Provider - Skilled Nursing Facility 0244531945 Practice locations: Orlando, FL

Skilled nursing facility certification: CCN 105960

Legal name
SOLARIS HEALTHCARE WINDERMERE LLC
Doing business as
SOLARIS HEALTHCARE WINDERMERE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jun 18, 1997
Last certification
Jul 11, 2024
Beds
120
Ownership / control type
Other Nonprofit
Most recent change of ownership
Jan 1, 2011
Organization structure
LLCNon-profit
Incorporated
Oct 6, 2015 in FL
Enrollment address
4875 Cason Cove Dr
Solaris Healthcare Windermere
Orlando, FL 32811-6302
Nursing home name
SOLARIS HEALTHCARE WINDERMERE
Affiliated entity
SOLARIS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Solaris Healthcare WindermereCCN 105960
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 18, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120115.0 residents per day on average
Chain
Solaris Healthcare22 facilities in the chain

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
10D0923233Solaris Healthcare Windermere4875 Cason Cove Dr, Orlando, FL 32811Certificate of waiverDec 17, 2026

National Provider Directory

National Provider Directory

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2016
Jauvid B Ayadi Individual Adp of the SNF Jan 1, 2016
Individual Adp of the SNF Jan 1, 2025
Shelby Parker Individual Adp of the SNF Oct 1, 2016
Shawn Corley Individual Corporate OfficerPresident, Solaris Healthcare Prop Jun 1, 2022
Operational/Managerial Control Jun 1, 2022
Managing Control - Governing BodyPresident Jun 1, 2022
Adp of the SNF Jun 1, 2022
Jessica Barrett Individual Corporate OfficerChief Nursing Officer May 16, 2022
Corporate DirectorBoard Member, Solaris HC Windermere May 16, 2022 33.33%
Operational/Managerial Control May 16, 2022
Individual Adp of the SNF Jan 1, 2025
Michael Berkowitz Individual Corporate DirectorBoard Member, Solaris Foundation Jun 1, 2022
Bobby Pate Individual Corporate OfficerPresident, Cfo and Administrator Jan 24, 2020 100%
Corporate DirectorBoard Member Solaris HC Windermere Jan 24, 2020 33.33%
Operational/Managerial ControlPresident, Cfo and Administrator Jan 24, 2020 100%
Managing Control - Governing BodyPresident/Cfo/Administrator Jan 24, 2020
Adp of the SNF Apr 10, 2025
Chaim Herzka Individual Corporate DirectorBoard Member, Solaris Foundation Jun 1, 2022
Joseph Oberlander Individual Corporate DirectorBoard Member, Solaris Foundation Jun 1, 2022
National Health Realty, LLC Organization, Murfreesboro, TN LLC Adp of the SNF Jan 1, 2016
Organization, Windermere, FL LLC, Consulting firm, For-profit Adp of the SNF Apr 10, 2025
Miriam Buxbaum Individual Corporate DirectorBoard Member, Solaris Foundation Jun 1, 2022
Organization, Pensacola, FL Corporation, Consulting firm Adp of the SNF Apr 10, 2025
Solaris Healthcare Properties LLC Organization, Windermere, FL LLC, Non-profit 5% Or Greater Indirect Ownership Interest Oct 6, 2015 100%
Windermere Healthcare Holdings, LLC Organization, Windermere, FL LLC, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Oct 20, 2015 100%
Organization, Murfreesboro, TN LLC Adp of the SNF Apr 10, 2025
Thomas Bell Individual Corporate OfficerCeo/President, Solaris Foundation Jun 1, 2022
Corporate DirectorBoard Member, Solaris Foundation Jun 1, 2022
Adp of the SNF Jan 1, 2016
Paulina Medina Individual Corporate OfficerSecretary Solaris HC Windermere Oct 28, 2024
Corporate DirectorBoard Member, Solaris HC Windermere Oct 28, 2024 33.33%
Operational/Managerial Control Oct 28, 2024
Solaris Foundation Inc. Organization, Windermere, FL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 6, 2015 100%

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 11

Facilities that share an organizational owner with 5% or greater ownership or operational 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": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1912378514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3310",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347863310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 CASON COVE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328116302",
            "telephone_number": "407-420-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLARIS HEALTHCARE WINDERMERE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-420-2090"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.