Pensacola Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PENSACOLA OPCO, LLC

Doing business as

Pensacola Nursing & Rehabilitation Center

Practice address

235 W Airport Blvd
Pensacola, FL 32505-2239

Phone

(850) 857-5200

Fax

(850) 477-2235

NPI assigned

Jan 25, 2022

Last updated

Jan 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mathew Varghese

Title

Member

Phone

(917) 817-3530

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pensacola Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922750405. Details of each certification follow.

• CCN 105935 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105935

Legal name

PENSACOLA OPCO, LLC

Doing business as

PENSACOLA NURSING & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 8, 1997

Last certification

Jan 9, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Aston Health

Organization structure

LLCProprietary

Incorporated

Dec 27, 2021 in DE

Enrollment address

235 W Airport Blvd
Pensacola, FL 32505-2239

Nursing home name

PENSACOLA NURSING & REHABILITATION CENTER

Affiliated entity

ASTON HEALTH

Listed as

Pensacola Nursing & Rehabilitation CenterCCN 105935 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 8, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120109.3 residents per day on average

Chain

Aston Health38 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 1

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

• Hima Reddy Devarapalli, MD

  • Hospitalist Physician
  • Mobile, AL
  • NPI 1003487521

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 2

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

• New Port Richey Opco, LLC

  dba Nursing & Rehabilitation Center of New Port Richey

  • Skilled Nursing Facility
  • New Port Richey, FL
  • NPI 1497407977

  SH Indigo Citadel Investors LLC

  CMS ownership
• Port Charlotte Opco, LLC

  dba Port Charlotte Center for Nursing & Rehabilitation

  • Skilled Nursing Facility
  • Port Charlotte, FL
  • NPI 1902558398

  SH Indigo Citadel Investors LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Cristina Rochelle Bunton-Young, M.D.

  • Internal Medicine Physician
  • Pensacola, FL
  • NPI 1104168525

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1922750405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 W AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325052239",
            "telephone_number": "850-857-5200",
            "fax_number": "850-477-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W AIRPORT BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325052239",
            "telephone_number": "850-857-5200",
            "fax_number": "850-477-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "VARGHESE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-817-3530"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "130470965",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pensacola",
            "affiliation": "N",
            "endpointDescription": "Pensacola OpCo, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "235 W Airport Blvd",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325052239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pensacola Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.

Verify at the official NPI Registry.