BRIDGEPORT HEALTH CARE CENTER, INC (NPI# 1003909623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003909623 |
| Entity Type | Organization |
| Organization Name | BRIDGEPORT HEALTH CARE CENTER, INC |
| Other Organization Name | BRIDGEPORT MANOR |
| Practice Address |
540 Bond Street Bridgeport CT 06610 |
| Practice Telephone | 2033846400 |
| Practice Fax Number | 2033846499 |
| Mailing Telephone | 2033846400 |
| Mailing Fax Number | 2033846499 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHRISTOPHER A MASSARO (ADMINISTRATOR) |
| Authorized Official Telephone | 2033846400 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2079-C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 9000020793 | 05 |
| Other Name | Type Code |
|---|---|
| Bridgeport Manor | Doing Business As Name - Organization |
| Street Address |
540 BOND STREET |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205171626 | Part Avenue Medical Associates, LLC | Skilled Nursing Facility | 80 Hooker Rd, Bridgeport, CT 06610-1316 | 2012-12-11 |
| 1033470786 | David Daryl Vaught | Skilled Nursing Facility | Rr 5 Box 108-c, Bridgeport, WV 26330 | 2012-05-30 |
| 1982918470 | Emericare Heritage LLC | Skilled Nursing Facility | Route 4, 17, Bridgeport, WV 26330-9804 | 2010-07-27 |
| 1376795146 | Robert Barry | Skilled Nursing Facility | 1413 Old Town Rd, Bridgeport, CT 06606-1442 | 2008-10-10 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| 1104946813 | The New Coleman Park | Skilled Nursing Facility | 62 Coleman St, Bridgeport, CT 06604-3419 | 2007-03-29 |
| 1891803490 | Heritage of Bridgeport, Inc | Skilled Nursing Facility | 505 O St, Bridgeport, NE 69336-4045 | 2006-08-25 |
| 1679515183 | Heartland-lansing of Bridgeport Oh LLC | Skilled Nursing Facility | 68222 Commercial Dr, Bridgeport, OH 43912-1520 | 2006-06-11 |
| 1558314955 | Northbridge Health Care Center, Inc. | Skilled Nursing Facility | 2875 Main Street, Bridgeport, CT 06606 | 2006-05-18 |
| 1972594182 | Parcc Healthcare Inc | Skilled Nursing Facility | 725 Park Avenue, Bridgeport, CT 06604 | 2005-11-04 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.