IVY AT DEER LODGE LLC – Skilled Nursing Facility, NPI 1356988349

IVY AT DEER LODGE LLC is a healthcare provider. based in Surfside, Florida. specializing in Skilled Nursing Facility. The NPI Number for IVY AT DEER LODGE LLC is 1356988349

Main info

Organization
Name
IVY AT DEER LODGE LLC
NPI
1356988349
Phone
(305) 912-9260
Address
9429 HARDING AVE # 141
Authorized Official
MR. RYAN MORRIS COANE CHIEF OPERATING OFFICER
Enumeration Date
9 December 2019
Last Update Date
12 January 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:6State licenses:0Digital endpointsOther names

Provider Addresses for IVY AT DEER LODGE LLC

  • 9429 HARDING AVE # 141

    SURFSIDE, FL 331542803

    Phone: (305) 912-9260

    Type: Mailing

  • 1100 TEXAS AVE

    DEER LODGE, MT 597221829

    Phone: (406) 846-1655

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20200512000587OSkilled Nursing FacilityMTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33154)

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Reviews

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Frequently asked questions

How do payers reference IVY AT DEER LODGE LLC?
For IVY AT DEER LODGE LLC, use NPI 1356988349 as the unique 10-digit identifier.
Is IVY AT DEER LODGE LLC still an active registrant?
IVY AT DEER LODGE LLC carries an active NPI according to the public dataset.
What expertise is attributed to IVY AT DEER LODGE LLC?
IVY AT DEER LODGE LLC's specialty line reads Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
Is IVY AT DEER LODGE LLC located near Surfside?
IVY AT DEER LODGE LLC currently maps to Surfside, Florida in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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