COMMUNITY CONVALESCENT CENTER OF MONTCLAIR INC

NPI: 1851388458 · MONTCLAIR, CA 91763 · Skilled Nursing Facility · NPI assigned 09/29/2005

$4K

Total Medicaid Paid

630

Total Claims

Beneficiaries

Codes Billed

2019-08

First Month

2020-05

Last Month

Provider Details

Authorized Official	SANCHEZ, ROSALIE (MANAGER)
NPI Enumeration Date	09/29/2005

Other providers sharing the same authorized official: SANCHEZ, ROSALIE

Provider	City	State	Total Paid
8520 WESTERN AVENUE INC	BUENA PARK	CA	$28K
533 SOUTH FAIRFAX AVENUE INC	LOS ANGELES	CA	$28K
GARDEN GROVE CONVALESCENT HOSPITAL INC	GARDEN GROVE	CA	$13K
1135 N LEISURE CT INC	ANAHEIM	CA	$6K
PACIFIC CARE NURSING CENTER	LONG BEACH	CA	$5K
12232 CHAPMAN AVE INC	GARDEN GROVE	CA	$0.00

Year	Claims	Total Paid
2019	611	$4K
2020	19	$83.68

Code	Description	Claims	Beneficiaries	Total Paid
97110	Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion	163	13	$3K
97530	Therapeutic activities, direct patient contact, each 15 minutes	204	13	$657.93
97112	Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination	197	13	$586.37
Q3014	Telehealth originating site facility fee	19	18	$83.68
97535	Self-care/home management training, each 15 minutes	47	12	$0.00