AUTUMN LAKE HEALTHCARE AT BRIDGEPARK
NPI 1831696509
Skilled Nursing Facility in Baltimore, MD
NPI Status: Active since April 10, 2018
Contact Information
4017 LIBERTY HEIGHTS AVE
BALTIMORE, MD
ZIP 21207
Phone: (877) 567-0402
Fax: (718) 567-0600
- Organization
- Skilled Nursing Facility
- CLIA Number: 21D0885002
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 04-13-2026
About AUTUMN LAKE HEALTHCARE AT BRIDGEPARK
This page provides the complete NPI Profile along with additional information for Autumn Lake Healthcare At Bridgepark, a provider established in Baltimore, Maryland operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1831696509 assigned on April 2018. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Autumn Lake Healthcare At Bridgepark. The authorized official of this NPI record is Sam Stern (Cfo)
- NPI
- 1831696509
- Provider Legal Name
- BRIDGEPARK OPERATIONS, LLC
- Other Organization Name
- AUTUMN LAKE HEALTHCARE AT BRIDGEPARK
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4017 LIBERTY HEIGHTS AVE BALTIMORE, MD 21207
- Location Phone
- (877) 567-0402
- Location Fax
- (718) 567-0600
- Mailing Address
- 14C 53RD ST STE 220 BROOKLYN, NY 11232
- Mailing Phone
- (718) 567-0400
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-10-2018
- Last Update Date
- 05-04-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License State
- MD
- Taxonomy Description
- (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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 385H00000X | Respite Care Facility | Respite Care | (MD) |
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 this NPI number is:
- CLIA Number
- 21D0885002
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- April 14, 2024
- Certificate Expiration Date
- April 13, 2026
- Laboratory Director
- NARENDER BHARAJ
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Autumn Lake Healthcare At Bridgepark 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.
Reviews for AUTUMN LAKE HEALTHCARE AT BRIDGEPARK
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1831696509, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
BALTIMORE, MD 21207
BALTIMORE, MD 21207
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1831696509, enumerated as an "organization" on April 10, 2018.
The provider is located at 4017 LIBERTY HEIGHTS AVE BALTIMORE, MD 21207 and the phone number is (877) 567-0402.
Skilled Nursing Facility with taxonomy code 314000000X.
