Sholom Home East Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

328527 Issued in MN

Legal business name

SHOLOM HOME EAST INC

Practice address

740 Kay Ave
Saint Paul, MN 55102-6014

Phone

(651) 328-2000

Fax

(651) 328-2070

NPI assigned

Dec 28, 2005

Last updated

May 14, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Wyckoff

Title

Controller

Phone

(952) 939-1637

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992782221. Details of each certification follow.

• CCN 245411 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245411

Legal name

SHOLOM HOME EAST INC

Doing business as

SHIRLEY CHAPMAN SHOLOM HOME EAST

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 1, 1987

Last certification

Apr 17, 2025

Beds

118

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Aug 27, 1906 in MN

Enrollment address

740 Kay Ave
St Paul, MN 55102-6014

Nursing home name

SHIRLEY CHAPMAN SHOLOM HOME EAST

Listed as

Shirley Chapman Sholom Home EastCCN 245411 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Feb 1, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11891.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 25

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jane Carol Pederson, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Minneapolis, MN
  • NPI 1508147224

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Marc A Salita, MD

  • Internal Medicine Physician
  • Richfield, MN
  • NPI 1588626824

  Corporate Director

  CMS ownership

Facilities with the same owner 1

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

• Sholom Home West Inc

  • Skilled Nursing Facility
  • St Louis Park, MN
  • NPI 1770560005

  Sholom Community Alliance

  CMS ownership

Practitioners 6

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.

• Christine Duncan, M.D.

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1497730931
  NPD (past)
• Elizabeth Margaret Fairbairn, MD

  • Internal Medicine Physician
  • Bloomington, MN
  • NPI 1982269684
  NPD (past)
• Sarah C Maier, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1710953427
  NPD (past)
• Rachel Erin Rivard-Horejsi, MD

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1447210984
  NPD (past)
• Himanshu S Sharma, MD

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1720040900
  NPD (past)
• Kurt Edward Walstrom, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1487853123
  NPD (past)

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Isaac Adediran, M.D

  • Family Medicine Physician
  • Golden Valley, MN
  • NPI 1063826998

  Nursing home

  Care Compare affiliation
• Christine Duncan, M.D.

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1497730931

  Nursing home

  Care Compare affiliation
• Sena Kihtir, MD

  • Pain Medicine Physician
  • Saint Paul, MN
  • NPI 1053422097

  Nursing home

  Care Compare affiliation
• Sarah C Maier, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1710953427

  Nursing home

  Care Compare affiliation
• Himanshu S Sharma, MD

  • Family Medicine Physician
  • Saint Paul, MN
  • NPI 1720040900

  Nursing home

  Care Compare affiliation
• Kurt Edward Walstrom, M.D.

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1487853123

  Nursing home

  Care Compare affiliation
• Amber Marie Winkelman, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Minneapolis, MN
  • NPI 1235457763

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1992782221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 KAY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551026014",
            "telephone_number": "651-328-2000",
            "fax_number": "651-328-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 KAY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551026014",
            "telephone_number": "651-328-2000",
            "fax_number": "651-328-2070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1554 Midway Pkwy",
            "address_purpose": "LOCATION",
            "city": "St Paul",
            "state": "MN",
            "postal_code": "55108",
            "country_code": "US",
            "telephone_number": "651-646-6311",
            "fax_number": "952-935-2701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHOLOM HOME EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "WYCKOFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "952-939-1637"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "00263",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8649SH",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0089",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122642",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529242500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7100365",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samiya Shire
• Bella Shklyarova, MD
• Barbara Jean Shock, MA, LMFT
• Terra Shockman, MD
• Adeline Sholar, RD, LD
• Shores Therapy, LLC
• Brenda Shores, LICSW
• Casi Marie Short, CRNA
• Shoshana Center for Reproductive Health Psychology, PLLC (Shoshana Center)
• Carol Jeanne Showalter, MD

• Skilled Nursing Facility in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; 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.

Verify at the official NPI Registry.