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NEW SURFSIDE NURSING HOME LLC
NPI 1063419612
Skilled Nursing Facility in Far Rockaway, NY

Active since June 28, 2005CLIA 33D0916085 · Waiver
2241 NEW HAVEN AVE, FAR ROCKAWAY, NY 11691(718) 471-3400(718) 471-2802 Get Directions Write a Review

NPPES record last updated: March 25, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About New Surfside Nursing Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEW SURFSIDE NURSING HOME LLC (NPI 1063419612) is a healthcare organization registered as a skilled nursing facility in Far Rockaway, New York and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Elizabeth Dunn, Controller, as its authorized official.

NPPES Registry Identity

NPI1063419612
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameNEW SURFSIDE NURSING HOME LLC
Location Address2241 NEW HAVEN AVEFar Rockaway, NY 11691-2538
Mailing Address2241 New Haven AveFar Rockaway, NY 11691-2538 · (718) 471-3400 · Fax (718) 471-2802
Phone(718) 471-3400
Fax(718) 471-2802
Organization SubpartNo
Authorized OfficialElizabeth DunnController · (718) 471-3400
Enumeration DateJune 28, 2005
Last NPPES UpdateMarch 25, 2008
✔ NPI 1063419612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in NY · 7003373N
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2241 NEW HAVEN AVE, Far Rockaway, NY 11691
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Other Identifiers 3

Medicare ID-Type Unspecified335165NY
Medicaid00309724NY
Medicare NSC1168180001NY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D0916085

New Surfside Nursing Home LLC · Far Rockaway, NY
Active · expires Mar 26, 2027
CLIA Number33D0916085
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 13, 1996
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Polina Rakhanina
Laboratory Phone(718) 471-3400
Laboratory LocationNew Surfside Nursing Home LLC22-41 New Haven Ave, Far Rockaway, NY 11691
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS JANE RENELLE BISA-CISTER NP
Nurse Practitioner (Adult Health)
2241 NEW HAVEN AVE
FAR ROCKAWAY, NY 11691
Queens County (718) 471-3400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is New Surfside Nursing Home LLC's NPI number?

The NPI number for New Surfside Nursing Home LLC is 1063419612. It was assigned to this organization in the NPPES registry on June 28, 2005.

Where is New Surfside Nursing Home LLC located?

New Surfside Nursing Home LLC is located at 2241 New Haven Ave, Far Rockaway, NY 11691. The listed phone number is (718) 471-3400.

What is New Surfside Nursing Home LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does New Surfside Nursing Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0916085) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for New Surfside Nursing Home LLC was last updated on March 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.