BROOKDALE ST. AUGUSTINE
NPI 1902132749
Assisted Living Facility in St Augustine, FL
NPI Status: Active since October 29, 2009
Contact Information
150 MARINER HEALTH WAY
ST AUGUSTINE, FL
ZIP 32086
Phone: (904) 794-9988
- Organization
- Assisted Living Facility
- CLIA Number: 10D1080868
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 03-03-2028
About BROOKDALE ST. AUGUSTINE
This page provides the complete NPI Profile along with additional information for Brookdale St. Augustine, a provider established in St Augustine, Florida operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1902132749 assigned on October 2009. The practitioner's primary taxonomy code is 310400000X with license number AL9908 (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 Brookdale St. Augustine. The authorized official of this NPI record is Anna Munoz (Assistant Secretary)
- NPI
- 1902132749
- Provider Legal Name
- SUMMERVILLE AT ST. AUGUSTINE, LLC
- Other Organization Name
- BROOKDALE ST. AUGUSTINE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 150 MARINER HEALTH WAY ST AUGUSTINE, FL 32086
- Location Phone
- (904) 794-9988
- Mailing Address
- 150 MARINER HEALTH WAY ST AUGUSTINE, FL 32086
- Mailing Phone
- (904) 794-9988
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-29-2009
- Last Update Date
- 09-30-2024
- 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
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- AL9908
- License State
- FL
- Taxonomy Description
- A 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0124330-00 | MEDICAID (05) | FL |
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
- 10D1080868
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- March 04, 2026
- Certificate Expiration Date
- March 03, 2028
- Laboratory Director
- CHAD ANSINSON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Brookdale St. Augustine 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 BROOKDALE ST. AUGUSTINE
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 1902132749, 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 13 providers are registered at the same or a nearby location.
ST AUGUSTINE, FL 32086
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902132749, enumerated as an "organization" on October 29, 2009.
The provider is located at 150 MARINER HEALTH WAY ST AUGUSTINE, FL 32086 and the phone number is (904) 794-9988.
Assisted Living Facility with taxonomy code 310400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
