Active NPI
Laurel Square Healthcare and Rehabilitation Center LLC
- Skilled Nursing Facility
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 131302
- Legal business name
- LAUREL SQUARE HEALTHCARE AND REHABILITATION CENTER LLC
- Practice address
- 1020 Oak Lane Ave
Philadelphia, PA 19126-3340 - Phone
- (732) 262-2255
- Fax
- (732) 262-3332
- NPI assigned
- Apr 1, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ben Friedman
- Title
- Controller
- Phone
- (732) 262-2255
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 131302 | PA | Primary |
Addresses
Primary practice location
1020 Oak Lane Ave
Philadelphia, PA 19126-3340
Mailing address
260 Chambers Bridge Rd
Brick, NJ 08723-2809
Phone (732) 262-2255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160812001289 | PA | Part A Provider - Skilled Nursing Facility | 4486947199 | Practice locations: Philadelphia, PA |
Skilled nursing facility certification: CCN 395535
- Legal name
- LAUREL SQUARE HEALTHCARE AND REHABILITATION CENTER, LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 21, 1982
- Last certification
- Sep 12, 2024
- Beds
- 87
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Nationwide Healthcare
- Organization structure
- LLC
- Incorporated
- Oct 8, 2015 in PA
- Enrollment address
- 1020 Oak Lane Avenue
Philadelphia, PA 19126-3340 - Nursing home name
- LAUREL SQUARE HEALTHCARE AND REHABILITATION CENTER
- Affiliated entity
- NATIONWIDE HEALTHCARE SERVICES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Laurel Square Healthcare and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jun 21, 1982
- Medicare certification status
- Active
- Certified beds
- 87
- Chain
- Nationwide Healthcare Services
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2165226 | Laurel Square Healthcare & Rehabilitation Center | Certificate of waiver | Apr 22, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nationwide Healthcare Services | Operational/Managerial Control | Oct 8, 2015 | |
| Sheldon Braun | 5% Or Greater Direct Ownership Interest | Oct 8, 2015 | 5% |
| Operational/Managerial Control | Oct 8, 2015 | 5% | |
| Other | Oct 8, 2015 | 5% | |
| Meir Gelley | 5% Or Greater Direct Ownership Interest | Oct 8, 2015 | 90% |
| Other | Oct 8, 2015 | 90% | |
| Leah Gelley | 5% Or Greater Indirect Ownership Interest | Oct 8, 2015 | 5% |
| Other | Oct 8, 2015 | 5% |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Philadelphia, PA
- NPI 1427302280
Nationwide Healthcare Services
-
- Skilled Nursing Facility
- Milford, DE
- NPI 1538700406
Nationwide Healthcare Services
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Family Medicine) Physician
- Narberth, PA
- NPI 1427005735
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Narberth, PA
- NPI 1427005735
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1459468800000",
"number": "1972966422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 CHAMBERS BRIDGE RD",
"city": "BRICK",
"state": "NJ",
"postal_code": "087232809",
"telephone_number": "732-262-2255",
"fax_number": "732-262-3332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 OAK LANE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191263340",
"telephone_number": "732-262-2255",
"fax_number": "732-262-3332"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAUREL SQUARE HEALTHCARE AND REHABILITATION CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-04-01",
"last_updated": "2016-04-01",
"status": "A",
"authorized_official_last_name": "FRIEDMAN",
"authorized_official_first_name": "BEN",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "732-262-2255"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "PA",
"license": "131302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.