Organization Active NPI

Edgwood Mi Opco LLC

  • Skilled Nursing Facility
  • Three Rivers, MI
National Provider Identifier
1962379404
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EDGWOOD MI OPCO LLC
Practice address
55378 Wilbur Rd
Three Rivers, MI 49093-8815
Phone
(732) 330-2157
NPI assigned
Oct 20, 2025
Last updated
Dec 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Esti Pruzansky
Title
Ar
Phone
(732) 330-2157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

55378 Wilbur Rd
Three Rivers, MI 49093-8815

Mailing address

175 Route 70 Ste 207
Toms River, NJ 08755-0936
Phone (732) 330-2157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251124000223 MI Part A Provider - Skilled Nursing Facility 2163914532 Practice locations: Three Rivers, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962379404. Details of each certification follow.

Skilled nursing facility certification: CCN 235354

Legal name
EDGWOOD MI OPCO LLC
Doing business as
THE ORCHARDS AT THREE RIVERS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1978
Last certification
Nov 15, 2024
Beds
87
Ownership / control type
Corporation
Multi-facility organization
The Orchards of Michigan
Organization structure
LLCProprietary
Enrollment address
55378 Wilbur Rd
Three Rivers, MI 49093-8815
Nursing home name
THE ORCHARDS AT THREE RIVERS
Affiliated entity
THE ORCHARDS MICHIGAN

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Orchards at Three RiversCCN 235354 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8775.3 residents per day on average
Chain
The Orchards Michigan15 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
2Fines totaling $137,535
Ownership change
Changed ownership in the last 12 months

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
23D0672271Orchards at Three Rivers, the55378 Wilbur Road, Three Rivers, MI 49093Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Garrett Smith Individual Operational/Managerial Control Nov 1, 2025
Adp of the SNF Nov 1, 2025
Isaac Gutman Individual 5% Or Greater Direct Ownership Interest Nov 1, 2025 40%
Operational/Managerial Control Nov 1, 2025
Managing Control - Governing BodyManaging Member Nov 1, 2025
Adp of the SNF Nov 1, 2025
Melissa S Teeple Individual Operational/Managerial Control Nov 1, 2025
Adp of the SNF Nov 1, 2025
White Lake Healthcare LLC Organization, Lakewood, NJ LLC, Management services company, Chain home office Operational/Managerial Control Nov 1, 2025
Adp of the SNF Nov 1, 2025
Jacob Taub Individual 5% Or Greater Direct Ownership Interest Nov 1, 2025 40%
Operational/Managerial Control Nov 1, 2025
Managing Control - Governing BodyManaging Member Nov 1, 2025
Adp of the SNF Nov 1, 2025
Alexander Hoffman Individual 5% Or Greater Direct Ownership Interest Nov 1, 2025 10%
Managing Control - Governing BodyMember Nov 1, 2025
Adp of the SNF Nov 1, 2025
Randy Roberts Individual Operational/Managerial Control Nov 1, 2025
Adp of the SNF Nov 1, 2025
Robert Kornfeld Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2025 10%
Operational/Managerial Control Nov 1, 2025
Managing Control - Governing BodyMember Nov 1, 2025
Adp of the SNF Nov 1, 2025

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 5

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

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1962379404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 207",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087550936",
            "telephone_number": "732-330-2157",
            "fax_number": "732-330-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55378 WILBUR RD",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938815",
            "telephone_number": "732-330-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGWOOD MI OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "PRUZANSKY",
        "authorized_official_first_name": "ESTI",
        "authorized_official_title_or_position": "AR",
        "authorized_official_telephone_number": "732-330-2157"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.