South Mountain Healthcare and Rehabilitation Center
Organization Active NPI Skilled Nursing Facility · Vauxhall, NJ
NPI 1962594770 · NPPES record last updated Jan 6, 2010
Key facts
- NPI
- 1962594770
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- SOUTH MOUNTAIN HEALTHCARE AND REHABILITATION CENTER
- Practice address
- 2385 Springfield Ave
Vauxhall, NJ 07088-1046 - Phone
- (908) 688-3400
- NPI assigned
- Sep 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Melvin Feigenbaum
- Title
- Partner
- Phone
- (908) 688-3400
Facilities with the same owner 9
Practitioners 1
-
Marina Zelener, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D0939606 | South Mountain Rehabilitation Center | Certificate of waiver | Jan 27, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Skilled nursing facility certification: CCN 315283A
- Legal name
- SOUTH MOUNTAIN HEALTHCARE AND REHABILITATION CENTER
- Organization structure
- LLC · Proprietary
- Enrollment address
- 2385 Springfield Avenue
Vauxhall, NJ 07088-1046 - Nursing home name
- SOUTH MOUNTAIN HC
- Affiliated entity
- OCEAN HEALTHCARE
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Dec 2, 2025 | |
| |
Adp of the SNF | Oct 1, 2024 | |
| Melvin Feigenbaum |
Adp of the SNF | Jan 1, 2008 | |
| Deborah F Feigenbaum |
5% Or Greater Direct Ownership Interest | Aug 7, 2007 | 70% |
| Direct Ownership Interest | Aug 7, 2007 | 70% | |
| Avraham R Feigenbaum |
5% Or Greater Direct Ownership Interest | Aug 3, 1989 | 10% |
| Operational/Managerial Control | Jan 1, 2008 | ||
| Adp of the SNF | Jan 1, 2008 | ||
| Direct Ownership Interest | Aug 3, 1989 | 10% | |
| Dynamic Healthcare Management LLC |
Operational/Managerial Control | Jan 1, 2008 | |
| Adp of the SNF | Dec 2, 2025 | ||
| Jacob Frommer |
5% Or Greater Direct Ownership Interest | Aug 3, 1989 | 20% |
| Direct Ownership Interest | Aug 3, 1989 | 20% | |
| |
Adp of the SNF | Dec 1, 2025 | |
| Brian Davis |
Operational/Managerial Control | Oct 30, 2023 | |
| Adp of the SNF | Oct 30, 2023 | ||
| |
Adp of the SNF | Dec 2, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100106000147 | NJ | Part a Provider - Skilled Nursing Facility | 0143361626 | Practice locations: Vauxhall, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
2385 Springfield Ave
Vauxhall, NJ 07088-1046
Mailing address
2385 Springfield Ave
Vauxhall, NJ 07088-1046
Phone (908) 688-3400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4504208 | Medicaid | NJ |
Other providers in Vauxhall, NJ
- Restored Mental Health Services
- Christina Robinson
- Sabrina Elena Rodriguez
- Hemang K Shah
- Solution Based Services
- Debra Southern
- Stadd Med Consult
- Strive Counseling Services, LLC
- Thee Program Foundation
- Aminatu Tiamiyu
All providers in Vauxhall, NJ · Skilled Nursing Facility in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.