Heritage Manor – Skilled Nursing Facility, NPI 1861419814

Heritage Manor is a healthcare provider. based in Youngstown, Ohio. specializing in Skilled Nursing Facility. The organization holds a License No. 3234 (OH). The NPI Number for Heritage Manor is 1861419814

Main info

Organization
Name
Heritage Manor
NPI
1861419814
Phone
(330) 884-6300
Address
517 GYPSY LN
Authorized Official
DAVID JOHN STAUFFER CFO CPA
Enumeration Date
16 July 2006
Last Update Date
5 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Heritage Manor

  • 517, East Gypsy Lane, Girard, Youngstown, Mahoning County, Ohio, 44504, United States

    YOUNGSTOWN, OH 445041314

    Phone: (330) 884-6300

    Fax: (330) 746-7926

    Mailing address matches the actual address.

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: 2012-03-14

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
O20120314000547OSkilled Nursing FacilityOHTBD

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

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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 44504)

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Reviews

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Frequently asked questions

What NPI should I save for Heritage Manor?
Save NPI 1861419814 if you need a stable reference for Heritage Manor.
Is Heritage Manor's NPI currently valid?
The extract we use shows Heritage Manor as active.
What does Heritage Manor treat or focus on?
Patients typically see Heritage Manor under the specialty Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
Where is Heritage Manor's primary listing?
We display Youngstown, Ohio because that is what the record indicates for Heritage Manor.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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