NPIMap

Organization Active NPI

Bedrock HCS at Watertown LLC

  • Skilled Nursing Facility
  • Watertown, WI
National Provider Identifier
1972154011
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BEDROCK HCS AT WATERTOWN LLC
Practice address
121 Hospital Dr
Watertown, WI 53098-3303
Phone
(920) 261-9220
NPI assigned
Sep 20, 2019
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Esther Tillim
Title
Bookkeeper
Phone
(732) 328-7499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

121 Hospital Dr
Watertown, WI 53098-3303

Mailing address

Workspace at Bitbean C/O Esther Tillim
1776 Ave of the States Suite 302
Lakewood, NJ 08701
Phone (732) 328-4977

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191114003072 WI Part A Provider - Skilled Nursing Facility 0648602565 Practice locations: Watertown, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972154011. Details of each certification follow.

Skilled nursing facility certification: CCN 525333

Legal name
BEDROCK HCS AT WATERTOWN LLC
Doing business as
WATERTOWN HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1983
Last certification
Nov 14, 2024
Beds
112
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Bedrock HCS
Most recent change of ownership
Oct 1, 2019
Organization structure
LLCProprietary
Incorporated
Jun 28, 2019 in WI
Enrollment address
121 Hospital Dr
Watertown, WI 53098-3303
Nursing home name
WATERTOWN HEALTH CARE CENTER
Affiliated entity
BEDROCK HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Watertown Health Care CenterCCN 525333 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11274.0 residents per day on average
Chain
Bedrock Healthcare9 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
7Fines totaling $278,229

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
52D0702268Bedrock HCS at Watertown LLC121 Hospital Dr, Watertown, WI 53098Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Martin Chopp Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2019 20%
Adp of the SNF Oct 1, 2019
Bedrock HC Wi LLC Organization, Lakewood, NJ Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2019 100%
Sandeep R Ramanujam Individual Operational/Managerial Control Feb 1, 2024
Adp of the SNF Feb 1, 2024
Opal Healthcare Wi LLC Organization, Toms River, NJ Management services company Operational/Managerial Control Oct 1, 2019
Adp of the SNF Mar 27, 2025
Solomon Chopp Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2019 20%
Adp of the SNF Oct 1, 2019
Pnina Chopp Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2019 60%
Adp of the SNF Oct 1, 2019
Raymond B Freson Individual Operational/Managerial Control Dec 24, 2024
Adp of the SNF Dec 24, 2024

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 6

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.

Affiliated clinicians 1

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": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1972154011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WORKSPACE AT BITBEAN C/O ESTHER TILLIM",
            "address_2": "1776 AVE OF THE STATES SUITE 302",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-328-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983303",
            "telephone_number": "920-261-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDROCK HCS AT WATERTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "TILLIM",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "732-328-7499"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.