NPIMap

Organization Active NPI

South Mountain Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • Vauxhall, NJ
National Provider Identifier
1962594770
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 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
Last updated
Jan 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Mr. Melvin Feigenbaum
Title
Partner
Phone
(908) 688-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2385 Springfield Ave
Vauxhall, NJ 07088-1046

Mailing address

2385 Springfield Ave
Vauxhall, NJ 07088-1046
Phone (908) 688-3400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100106000147 NJ Part A Provider - Skilled Nursing Facility 0143361626 Practice locations: Vauxhall, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962594770. Details of each certification follow.

Skilled nursing facility certification: CCN 315283A

Legal name
SOUTH MOUNTAIN HEALTHCARE AND REHABILITATION CENTER
Organization structure
LLCProprietary
Enrollment address
2385 Springfield Avenue
Vauxhall, NJ 07088-1046
Nursing home name
SOUTH MOUNTAIN HC
Affiliated entity
OCEAN HEALTHCARE

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
31D0939606South Mountain Rehabilitation Center2385 Springfield Avenue, Vauxhall, NJ 07088Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Organization, Lakewood, NJ Adp of the SNF Dec 2, 2025
Individual Adp of the SNF Oct 1, 2024
Melvin Feigenbaum Individual Adp of the SNF Jan 1, 2008
Deborah F Feigenbaum Individual 5% Or Greater Direct Ownership Interest Aug 7, 2007 70%
Direct Ownership Interest Aug 7, 2007 70%
Avraham R Feigenbaum Individual 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 Organization, Lakewood, NJ LLC, Consulting firm Operational/Managerial Control Jan 1, 2008
Adp of the SNF Dec 2, 2025
Jacob Frommer Individual 5% Or Greater Direct Ownership Interest Aug 3, 1989 20%
Direct Ownership Interest Aug 3, 1989 20%
Organization, Lakewood, NJ LLC Adp of the SNF Dec 1, 2025
Brian Davis Individual Operational/Managerial Control Oct 30, 2023
Adp of the SNF Oct 30, 2023
Organization, Brooklyn, NY Adp of the SNF Dec 2, 2025

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1962594770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 SPRINGFIELD AVE",
            "city": "VAUXHALL",
            "state": "NJ",
            "postal_code": "070881046",
            "telephone_number": "908-688-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 SPRINGFIELD AVE",
            "city": "VAUXHALL",
            "state": "NJ",
            "postal_code": "070881046",
            "telephone_number": "908-688-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MOUNTAIN HEALTHCARE AND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "FEIGENBAUM",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "908-688-3400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vauxhall, NJ

Sources for this page

Verify at the official NPI Registry.