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BROADWAY HEALTHCARE CENTER
NPI 1477547024
Skilled Nursing Facility in San Gabriel, CA

Active since September 08, 2005CLIA 05D0718873 · Waiver
5/5
Overall Rating
112 EAST BROADWAY, SAN GABRIEL, CA 91776(626) 285-2165(626) 287-4061 Get Directions Write a Review

NPPES record last updated: July 21, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Broadway Healthcare Center NPPES

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

BROADWAY HEALTHCARE CENTER (NPI 1477547024) is a healthcare organization registered as a skilled nursing facility in San Gabriel, California and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jacob Wintner, Manager, as its authorized official.

NPPES Registry Identity

NPI1477547024
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameAG SAN GABRIEL, LLC
Location Address112 EAST BROADWAYSan Gabriel, CA 91776
Mailing Address112 East BroadwaySan Gabriel, CA 91776 · (626) 285-2165 · Fax (310) 574-1322
Phone(626) 285-2165
Fax(626) 287-4061
Organization SubpartNo
Authorized OfficialJacob WintnerManager · (323) 651-1808
Enumeration DateSeptember 8, 2005
Last NPPES UpdateJuly 21, 2014
✔ NPI 1477547024 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 CA · 950000016
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.
112 EAST BROADWAY, San Gabriel, CA 91776
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Other Names 1

Doing Business AsBroadway Healthcare Center

Other Identifiers 2

MedicaidZZT05592ICA
Medicare OSCAR/certification056201CA

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 05D0718873

Ag San Gabriel LLC Dba Broadway Healthcare Center · San Gabriel, CA
Active · expires Aug 31, 2026
CLIA Number05D0718873
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorOscar L. Chien
Laboratory Phone(626) 285-2165
Laboratory LocationAg San Gabriel LLC Dba Broadway Healthcare Center112 E Broadway, San Gabriel, CA 91776
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Broadway Healthcare Center (CMS certification number 056201), from CMS Care Compare.

Broadway Healthcare Center

Nursing home · San Gabriel, CA
5/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number056201
Certified Beds59 beds56 residents per day on average
Medicare & Medicaid Participant SinceSeptember 22, 1971
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
5/5
Long-Stay Quality
Quality of care delivered to long-term residents.
5/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
62.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.42 · LPN 1.09 · RN 0.26
3.78 hrs per resident per day
Weekend Nurse Staffing
3.62 hrs per resident per day
Physical Therapist Staffing
0.07 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
27.9%
Registered Nurse Turnover
57.1%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
2
Substantiated Complaints
5
Fines
1 totaling $3,145.35
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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 Ag San Gabriel, LLC's NPI number?

The NPI number for Ag San Gabriel, LLC is 1477547024. It was assigned to this organization in the NPPES registry on September 8, 2005. The provider is doing business as Broadway Healthcare Center.

Where is Ag San Gabriel, LLC located?

Ag San Gabriel, LLC is located at 112 East Broadway, San Gabriel, CA 91776. The listed phone number is (626) 285-2165.

What is Ag San Gabriel, LLC's specialty?

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

Does Ag San Gabriel, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0718873) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Ag San Gabriel, LLC a Medicare-certified nursing home?

Yes. Broadway Healthcare Center is a Medicare-certified nursing home with 59 certified beds.

What quality rating does Ag San Gabriel, LLC have?

CMS rates Broadway Healthcare Center 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Ag San Gabriel, LLC was last updated on July 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.