200 GOVERNORS OPCO LLC

NPI: 1053178582 · MEDFORD, MA 02155 · Skilled Nursing Facility · NPI assigned 03/01/2024

Billing Flags · Automated signals — not evidence of fraud

Entity Proliferation

Authorized official MIRLIS, ELIYAHU controls 16+ related entities in our dataset. Read more

$74K

Total Medicaid Paid

138

Total Claims

Beneficiaries

Codes Billed

2024-07

First Month

2024-11

Last Month

Provider Details

Authorized Official	MIRLIS, ELIYAHU (OWNER)
NPI Enumeration Date	03/01/2024

Other providers sharing the same authorized official: MIRLIS, ELIYAHU

Provider	City	State	Total Paid
OC AZURE OF WORCESTER CENTER LLC	WORCESTER	MA	$981K
REGAL CARE AT HARWICH LLC	HARWICH	MA	$668K
RC HOLYOKE LLC	HOLYOKE	MA	$161K
MAPLEWOOD OPCO LLC	AMESBURY	MA	$60K
30 PRINCETON OPCO LLC	LOWELL	MA	$37K
REGALCARE AT TORRINGTON LLC	WATERBURY	CT	$27K
REGALCARE AT WEST HAVEN LLC	WATERBURY	CT	$20K
SAUGUS OPCO LLC	SAUGUS	MA	$15K
REGALCARE AT NEW HAVEN LLC	WATERBURY	CT	$15K
REGALCARE AT WATERBURY LLC	WATERBURY	CT	$13K
FAIRVIEW HEALTH OF GREENWICH LLC	GREENWICH	CT	$11K
RC GREENFIELD LLC	GREENFIELD	MA	$4K
TWIN OAKS OPCO LLC	DANVERS	MA	$2K
RC TAUNTON LLC	TAUNTON	MA	$945.25
RC QUINCY LLC	QUINCY	MA	$0.00
120 MURRAY OPCO LLC	MEDFORD	MA	$0.00

Year	Claims	Total Paid
2024	138	$74K

Code	Description	Claims	Beneficiaries	Total Paid
S0340	Lifestyle modification program for management of coronary artery disease, including all supportive services; first quarter / stage	138	77	$74K