FIVE STAR PREMIER RESIDENCES OF POMPANO BEACH (SNH SE TENANT TRS, INC) NPI 1366976961

Assisted Living Facility in Pompano Beach, FL

NPI 1366976961 Organization Assisted Living Facility CLIA Number 10D2132116 CLIA Certificate of Waiver

NPI Profile for FIVE STAR PREMIER RESIDENCES OF POMPANO BEACH (SNH SE TENANT TRS, INC)

Five Star Premier Residences Of Pompano Beach (snh Se Tenant Trs, Inc) is a provider established in Pompano Beach, Florida specializing in assisted living facility. The NPI number of Five Star Premier Residences Of Pompano Beach (snh Se Tenant Trs, Inc) is 1366976961 and was assigned on April 2017. The practitioner's primary taxonomy code is 310400000X with license number ALF7702 (FL). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Five Star Premier Residences Of Pompano Beach. The authorized official of this NPI record is Jennifer F Mintzer (President & Chief Operating Officer)

The CLIA number of Five Star Premier Residences Of Pompano Beach is 10D2132116 registered as a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Five Star Premier Residences Of Pompano Beach to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1366976961

Provider NameFIVE STAR PREMIER RESIDENCES OF POMPANO BEACH (SNH SE TENANT TRS, INC)
Provider Location Address1371 S OCEAN BLVD POMPANO BEACH, FL 33062
Provider Mailing Address1371 S OCEAN BLVD POMPANO BEACH, FL 33062
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Other Organization NameFIVE STAR PREMIER RESIDENCES OF POMPANO BEACH
Other Name TypeDoing Business As (3)
Enumeration Date04-20-2017
Last Update Date04-30-2020


Primary Taxonomy

Taxonomy Code310400000X
ClassificationAssisted Living Facility
TypeNursing & Custodial Care Facilities
License No.ALF7702
License StateFL
Taxonomy DescriptionA facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Business Address

FIVE STAR PREMIER RESIDENCES OF POMPANO BEACH
1371 S OCEAN BLVD
POMPANO BEACH, FL
ZIP 33062
Phone: (954) 943-1155

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Mailing Address

FIVE STAR PREMIER RESIDENCES OF POMPANO BEACH
1371 S OCEAN BLVD
POMPANO BEACH, FL
ZIP 33062
Phone:



Authorized Official

Authorized Official Name JENNIFER F MINTZER
Authorized Official TitlePRESIDENT & CHIEF OPERATING OFFICER
Authorized Official Phone(617) 796-8350

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1366976961 is:

CLIA Number10D2132116
Facility TypeASSISTED LIVING FACILITY
Certificate TypeCertificate of Waiver

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1366976961
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2312618712912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 2 + 6 + 1 + 8 + 7 + 1 + 2 + 9 + 1 + 2 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1366976961 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902096464 ELIZABETH F BREEDING OTR
Individual
Occupational Therapist1371 S OCEAN BLVD
POMPANO BEACH, FL 33062
(954) 785-8229
1699788596MRS. SUSAN EVELYN SHAFRAN LCSW
Individual
Social Worker (Clinical)1371 S OCEAN BLVD
POMPANO BEACH, FL 33062
(954) 943-1155
1255621736MR. RICHARD EDWARD VERDUN MS OTR/L
Individual
Occupational Therapist1371 S OCEAN BLVD
POMPANO BEACH, FL 33062
(954) 545-7155
1689085342 ANDREA VAZQUEZ DPT
Individual
Physical Therapist1371 S OCEAN BLVD
POMPANO BEACH, FL 33062
(954) 545-7155

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Five Star Premier Residences Of Pompano Beach is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.