Delmar Gardens of O'Fallon, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

044756 Issued in MO

Legal business name

DELMAR GARDENS OF O'FALLON, LLC

Doing business as

Delmar Gardens of O'Fallon

Practice address

7068 S Outer 364
O Fallon, MO 63368-7757

Phone

(636) 240-6100

Fax

(636) 240-1182

NPI assigned

Sep 16, 2005

Last updated

Mar 9, 2017By 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

Mr. Gail Lee Hartmann

Title

Treasurer

Phone

(636) 733-7000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Delmar Gardens of O'Fallon Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942295803. Details of each certification follow.

• CCN 265792 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265792

Legal name

DELMAR GARDENS OF O'FALLON, LLC

Doing business as

DELMAR GARDENS OF O'FALLON

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Dec 15, 2004

Last certification

May 14, 2024

Beds

240 (198 certified)

Ownership / control type

Limited Liability Corporation

Multi-facility organization

DELMAR GARDENS ENTERPRISES

Organization structure

LLCProprietary

Incorporated

Sep 24, 2004 in MO

Enrollment address

7068 S Outer 364
O Fallon, MO 63368-7757

Nursing home name

DELMAR GARDENS OF O'FALLON

Affiliated entity

DELMAR GARDENS

Listed as

Delmar Gardens of O'FallonCCN 265792 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Dec 15, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

198160.5 residents per day on average

Chain

Delmar Gardens12 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 16

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.

• George T Grossberg, MD

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1033135991

  5% Or Greater Indirect Ownership Interest, Other

  CMS ownership

Facilities with the same owner 16

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

• Delmar Gardens Home Care, Inc.

  dba Delmar Gardens Home Care

  • Home Health Agency
  • Chesterfield, MO
  • NPI 1295720118

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens North Operating, LLC

  dba Delmar Gardens North

  • Skilled Nursing Facility
  • Black Jack, MO
  • NPI 1750376612

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Chesterfield Operating, LLC

  dba Delmar Gardens of Chesterfield

  • Skilled Nursing Facility
  • Chesterfield, MO
  • NPI 1861487712

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Creve Coeur Operating, LLC

  dba Delmar Gardens of Creve Coeur

  • Skilled Nursing Facility
  • Creve Coeur, MO
  • NPI 1265427124

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Meramec Valley Operating, LLC

  dba Delmar Gardens of Meramec Valley

  • Skilled Nursing Facility
  • Fenton, MO
  • NPI 1013903525

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of South County, Inc.

  dba Delmar Gardens South

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1659366516

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens on the Green Operating, LLC

  dba Delmar Gardens on the Green

  • Skilled Nursing Facility
  • Chesterfield, MO
  • NPI 1841285798

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens West Operating, LLC

  dba Delmar Gardens West

  • Skilled Nursing Facility
  • Town & Country, MO
  • NPI 1043206584

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Pathways Community Hospice, LLC

  dba Pathways Hospice and Palliative Care

  • Community Based Hospice Care Agency
  • Chesterfield, MO
  • NPI 1447245360

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Gwinnett Operating, LLC

  dba Delmar Gardens of Gwinnett

  • Skilled Nursing Facility
  • Lawrenceville, GA
  • NPI 1255327862

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Lenexa Operating, LLC

  dba Delmar Gardens of Lenexa

  • Skilled Nursing Facility
  • Lenexa, KS
  • NPI 1336134295

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership
• Delmar Gardens of Omaha, LLC

  dba St. Joseph Villa

  • Skilled Nursing Facility
  • Omaha, NE
  • NPI 1417942277

  Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T

  CMS ownership

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.

• Panduranga Rao Koya, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1427151323
  NPD (past)
• Roohi Siraj, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Belleville, IL
  • NPI 1760885693
  NPD (past)

Affiliated clinicians 2

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

• Panduranga Rao Koya, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1427151323

  Nursing home

  Care Compare affiliation
• Roohi Siraj, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Belleville, IL
  • NPI 1760885693

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1942295803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14805 N OUTER 40 RD",
            "address_2": "SUITE 300",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630176060",
            "telephone_number": "636-733-7000",
            "fax_number": "636-733-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7068 S OUTER 364",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687757",
            "telephone_number": "636-240-6100",
            "fax_number": "636-240-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELMAR GARDENS OF O'FALLON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "HARTMANN",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "636-733-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "044756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101451607",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delmar Gardens of O'Fallon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• DDK, LC
• DDK, LLC
• Michael Jason Dean, RN ANP
• David Christopher Declue, D.C.
• Ryan Degeeter, PT
• Tara Nicole Demand, RN
• Alexander Dematteis IV, ED.D.
• Curtis Edmund Denham, LPC
• Dennis Senderovich D.D.S., P.C. (O'Fallon Dental Care)
• Dental Safari Co Missouri, PC

• Skilled Nursing Facility in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.