820 Nw 95TH Street Operations LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 1658781166 Enrollment ID O20201111001605

Linked facilitiesFacilities

StatesStates

15 parties: 8 organizations · 7 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Pamela Shaw	5991169336	Individual	Operational/Managerial Control	100
Tianziang Zhou	4183160088	Individual	Operational/Managerial Control	100
Aaron H Robin	8426969536	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control	50
Avrohom L Tress	5799087821	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer; Operational/Managerial Control	50
Nishita Bhumkar	5890832356	Individual	Operational/Managerial Control; ADP of the SNF	—
Jose Brito	7517351984	Individual	Operational/Managerial Control; ADP of the SNF	—
Bq Operations Holdings LLC	2769819846	Organization	5% or Greater Direct Ownership Interest	100
Newgen LLC	3577990654	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	100
Bold Quail Holdings LLC	1850728932	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	100
9560 Pico LLC	0648608315	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	50
Pico Ar LLC	2466880133	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	50
Michael T Berg	8325956121	Individual	Corporate Officer	100
820 Nw 95TH Street Property LLC	7911403522	Organization	ADP of the SNF	—
Bq Realty Holdings LLC	2466975412	Organization	ADP of the SNF	—
Newgen Administrative Services, LLC	3971025081	Organization	ADP of the SNF	—

Pamela ShawPAC 5991169336
Individual100Operational/Managerial Control
Tianziang ZhouPAC 4183160088
Individual100Operational/Managerial Control
Aaron H RobinPAC 8426969536
Individual505% or Greater Indirect Ownership Interest; Corporate Officer
Avrohom L TressPAC 5799087821
Individual505% or Greater Indirect Ownership Interest; Corporate Officer
Nishita BhumkarPAC 5890832356
IndividualOperational/Managerial Control; ADP of the SNF
Jose BritoPAC 7517351984
IndividualOperational/Managerial Control; ADP of the SNF
Bq Operations Holdings LLCPAC 2769819846
Organization1005% or Greater Direct Ownership Interest
Newgen LLCPAC 3577990654
Organization1005% or Greater Indirect Ownership Interest; ADP of the SNF
Bold Quail Holdings LLCPAC 1850728932
Organization1005% or Greater Indirect Ownership Interest; ADP of the SNF
9560 Pico LLCPAC 0648608315
Organization505% or Greater Indirect Ownership Interest; ADP of the SNF
Pico Ar LLCPAC 2466880133
Organization505% or Greater Indirect Ownership Interest; ADP of the SNF
Michael T BergPAC 8325956121
Individual100Corporate Officer
820 Nw 95TH Street Property LLCPAC 7911403522
OrganizationADP of the SNF
Bq Realty Holdings LLCPAC 2466975412
OrganizationADP of the SNF
Newgen Administrative Services, LLCPAC 3971025081
OrganizationADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Ballard Center 820 Nw 95TH Street Operations LLC 98 residents		Other disclo…	3.44	Ovr★★☆☆☆Stf★★★★☆Ins★★☆☆☆QM★★★☆☆	98

Ballard Center
820 Nw 95TH Street Operations LLC
Other disclosed role98 res3.44 HPRD
Overall 2Staffing Staff 4

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
10/01/2020	Ballard Center	820 Nw 95TH Street Operations LLC	Sunbridge Healthcare LLC	Buyer

10/01/2020
Ballard Center (Buyer)
Sunbridge Healthcare LLC → 820 Nw 95TH Street Operations LLC

Related CMS associates

Name match to 820 Nw 95TH Street Operations LLC in FEC filings. Similar names may appear—confirm on FEC.gov.