1086 Dumont Circle Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

1086 DUMONT CIRCLE OPCO LLC

Practice address

1086 Dumont Cir
Voorhees, NJ 08043-3500

Phone

(856) 454-9100

NPI assigned

Dec 27, 2023

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 3

Addresses

Other names 1

• Autumn Lake Healthcare at Voorhees Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Skilled nursing facility certification: CCN 315500

Legal name

1086 DUMONT CIRCLE OPCO LLC

Doing business as

AUTUMN LAKE HEALTHCARE AT VOORHEES

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 13, 2007

Last certification

Jan 26, 2024

Beds

120

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Jan 1, 2024 in NJ

Enrollment address

1086 Dumont Cir
Voorhees, NJ 08043-3500

Nursing home name

AUTUMN LAKE HEALTHCARE AT VOORHEES

Affiliated entity

AUTUMN LAKE HEALTHCARE

Listed as

Autumn Lake Healthcare at VoorheesCCN 315500

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

Feb 13, 2007

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120111.1 residents per day on average

Chain

Autumn Lake Healthcare59 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $84,835

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 6

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.

• Andrew Paul Pecora, D.O.

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1376637553

  Adp of the SNF

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leonard A Powell Jr., D. O.

  • Geriatric Medicine (Family Medicine) Physician
  • Stratford, NJ
  • NPI 1750644928
  NPD (past)

Affiliated clinicians 4

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

• Sneh Jain, MD

  • Internal Medicine Physician
  • Blackwood, NJ
  • NPI 1912971730

  Nursing home

  Care Compare affiliation
• Leonard A Powell Jr., D. O.

  • Geriatric Medicine (Family Medicine) Physician
  • Stratford, NJ
  • NPI 1750644928

  Nursing home

  Care Compare affiliation
• Timothy Lamar Rhyme, M.D.

  • Family Medicine Physician
  • Vineland, NJ
  • NPI 1992734974

  Nursing home

  Care Compare affiliation
• Que-CHI Vuong Wong, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Laurel Springs, NJ
  • NPI 1558314641

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1952170342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322646",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 DUMONT CIR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433500",
            "telephone_number": "856-454-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1086 DUMONT CIRCLE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare at Voorhees",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Voorhees, NJ
• Skilled Nursing Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.