NPIMap

Organization Active NPI

Promenade Nursing Home, Inc

  • Skilled Nursing Facility
  • Rockaway Park, NY
National Provider Identifier
1992856751
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
7003386N Issued in NY
Legal business name
PROMENADE NURSING HOME, INC
Practice address
140 Beach 114TH St
Rockaway Park, NY 11694-2405
Phone
(718) 945-4600
Fax
(718) 634-8237
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Mr. Peter Gross
Title
Associate Administrator
Phone
(718) 945-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 7003386N NY Primary

Addresses

Primary practice location

140 Beach 114TH St
Rockaway Park, NY 11694-2405

Mailing address

140 Beach 114TH St
Rockaway Park, NY 11694-2405
Phone (718) 945-4600

Other identifiers 1

IdentifierTypeStateIssuer
00308907MedicaidNY

Other names 1

  • Promenade Rehabilitation and Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090120000252 NY Part A Provider - Skilled Nursing Facility 5597828418 Practice locations: Rockaway Park, NY

Skilled nursing facility certification: CCN 335292

Legal name
PROMENADE NURSING HOME, INC
Doing business as
PROMENADE REHABILITATION & HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 12, 1970
Last certification
Aug 7, 2024
Beds
240
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1994 in NY
Enrollment address
140 Beach 114TH St
Rockaway Park, NY 11694-2405
Nursing home name
PROMENADE REHABILITATION AND HEALTH CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Promenade Rehabilitation and Health Care CenterCCN 335292
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 12, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
240229.7 residents per day on average

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
33D2064444Promenade Rehabilitation and Health Care140 Beach 114TH Street, Rockaway Park, NY 11694Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Soloman Vogel Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009 9.99%
Corporate OfficerVice President Apr 2, 2012
Corporate DirectorBoard Member Apr 2, 2012
Hadassa Nussbaum Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009 8%
Aviva Kiffel Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009 9.99%
Moshe Kalter Individual 5% Or Greater Direct Ownership Interest Oct 1, 2000 23%
Aliza Maierovits Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009 8%
Aaron Fogel Individual 5% Or Greater Direct Ownership Interest23 Oct 1, 2000
Karen S Gross Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009 8%
Peter Gross Individual Corporate OfficerVice President Jan 1, 1994 4%
Corporate DirectorBoard Member Apr 2, 2012 4%
W-2 Managing Employee May 26, 2022

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1992856751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BEACH 114TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942405",
            "telephone_number": "718-945-4600",
            "fax_number": "718-634-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BEACH 114TH ST",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942405",
            "telephone_number": "718-945-4600",
            "fax_number": "718-634-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMENADE NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "ASSOCIATE ADMINISTRATOR",
        "authorized_official_telephone_number": "718-945-4600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7003386N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00308907",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promenade Rehabilitation and Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockaway Park, NY

Sources for this page

Verify at the official NPI Registry.