MASSAPEQUA CENTER REHABILITATION AND NURSING
NPI 1104355536
Skilled Nursing Facility in Amityville, NY

Active since June 08, 2017CLIA 33D2133592 · Waiver
101 LOUDEN AVE., AMITYVILLE, NY 11701(631) 264-0222 Get Directions Write a Review

NPPES record last updated: August 14, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 14, 2024, Mar 27, 2018, Jun 8, 2017 (3 updates tracked since 2017).

About Massapequa Center Rehabilitation And Nursing NPPES

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

MASSAPEQUA CENTER REHABILITATION AND NURSING (NPI 1104355536) is a healthcare organization registered as a skilled nursing facility in Amityville, New York and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through March 26, 2027, maintains a secondary practice location in Amityville, and lists Joel Edelstein, Manager, as its authorized official.

NPPES Registry Identity

NPI1104355536
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMASSAPEQUA CENTER LLC
Location Address101 LOUDEN AVE.Amityville, NY 11701
Mailing Address101 Louden Ave.Amityville, NY 11701 · (631) 264-0222
Organization SubpartNo
Authorized OfficialJoel EdelsteinManager · (718) 888-5206
Enumeration DateJune 8, 2017
Last NPPES UpdateAugust 14, 20243 updates tracked since enumeration
NPPES CertifiedAugust 14, 2024
NPI 1104355536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
101 LOUDEN AVE., Amityville, NY 11701

Other Names 1

Doing Business AsMassapequa Center Rehabilitation And Nursing

Secondary Practice Location 1

Location 1399 County Line RoadAmityville, NY 11701 · Phone (718) 888-5200 ext. 205

Other Identifiers 1

Medicaid00314181NY

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 33D2133592

Massapequa Center Rehabilitation And Nursing · Amityville, NY
Active · expires Mar 26, 2027
CLIA Number33D2133592
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 17, 2017
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Olaf Butchma
Laboratory Phone(631) 264-0222
Laboratory LocationMassapequa Center Rehabilitation And Nursing101 Louden Ave, Amityville, NY 11701
CLIA data matches this NPI record on: Address 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.

Clinic/Center (Adult Day Care)
101 LOUDEN AVE.
AMITYVILLE, NY 11701

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 Massapequa Center LLC's NPI number?

The NPI number for Massapequa Center LLC is 1104355536. It was assigned to this organization in the NPPES registry on June 8, 2017. The provider is doing business as Massapequa Center Rehabilitation And Nursing.

Where is Massapequa Center LLC located?

Massapequa Center LLC is located at 101 Louden Ave., Amityville, NY 11701. The listed phone number is (631) 264-0222.

What is Massapequa Center LLC's specialty?

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

Does Massapequa Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2133592) 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 Massapequa Center LLC was last updated on August 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.