MASONICARE HEALTH CENTER (NPI# 1043690100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043690100 |
| Entity Type | Organization |
| Organization Name | MASONICARE HEALTH CENTER |
| Practice Address |
22 Masonic Ave Wallingford CT 06492-3048 |
| Practice Telephone | 2036795959 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Authorized Official Name | AUDREY WEBBER (PT) |
| Authorized Official Telephone | 2036795959 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | Y |
| Parent Organization Name | MASONICARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 10225 | CT | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235500497 | Masonicare Health Center | Skilled Nursing Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2015-10-14 |
| 1306212188 | Masonicare Health Center | Skilled Nursing Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2015-08-17 |
| 1427250885 | Masonicare Health Center | Prosthetic/Orthotic Supplier | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2007-06-05 |
| 1356558472 | Masonicare Health Center | Nursing Facility/Intermediate Care Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2007-05-17 |
| 1588638688 | Masonicare Health Center | Clinic/Center | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2006-02-15 |
| 1629061593 | Masonicare Health Center | Clinic/Center | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-08-25 |
| 1265425136 | Masonicare Health Center | Skilled Nursing Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-08-25 |
| 1174516041 | Masonicare Health Center | Chronic Disease Hospital | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-08-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MASONICARE HEALTH CENTER | C/o Murtha Cullina LLP, Cityplace I, 185 Asylum Street, Hartford, CT 06103-3469 |
| Street Address |
22 MASONIC AVE |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-3048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780689836 | Masonic Healthcare Center | Pharmacy | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2005-06-16 |
| 1841805397 | Nicholas Metaxas | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-09-11 |
| 1841813102 | Elena Bochicchio | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-05-21 |
| 1245852151 | Annemieke Ausloos Martino | Physical Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2020-05-13 |
| 1457992216 | Alison Lorusso | Nurse Practitioner | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-10-03 |
| 1467014183 | Debbra Konopaske | Physical Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-07-02 |
| 1306305776 | Sarnia Scarlett | Occupational Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-15 |
| 1902364888 | Elizabeth Fox | Speech-Language Pathologist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-09 |
| 1891253415 | Kathleen Robak | Occupational Therapy Assistant | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2019-03-04 |
| 1558831941 | Jeffrey Raymond Necio | Pharmacist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2018-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| 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 |
|---|---|---|---|---|
| 1275918443 | 55 Kondracki Lane Operations LLC | Skilled Nursing Facility | 55 Kondracki Ln, Wallingford, CT 06492-4951 | 2015-07-29 |
| 1063604601 | Club Staffing | Skilled Nursing Facility | 1345 Whirlwind Hill Rd, Wallingford, CT 06492-2727 | 2007-08-17 |
| 1528126232 | Regency House of Wallingford, Inc. | Skilled Nursing Facility | 181 E Main St, Wallingford, CT 06492-3947 | 2006-12-05 |
| 1558306985 | Health Resources of Wallingford, Inc. | Skilled Nursing Facility | 35 Marc Dr, Wallingford, CT 06492-5708 | 2006-06-19 |
| 1669429288 | Wallingford Nursing and Rehabilitation Center-wallingford Pa, LLC | Skilled Nursing Facility | 115 S Providence Rd, Wallingford, PA 19086-6333 | 2006-05-28 |
| 1083607543 | Brook Hollow Health Care Center LLC | Skilled Nursing Facility | 55 Kondracki Lane, Wallingford, CT 06492-4951 | 2005-08-30 |
| 1023576790 | Sv Opco LLC | Skilled Nursing Facility | 35 Marc Dr, Wallingford, CT 06492-5708 | 2019-03-12 |
| 1235500497 | Masonicare Health Center | Skilled Nursing Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2015-10-14 |
| 1306212188 | Masonicare Health Center | Skilled Nursing Facility | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2015-08-17 |
| 1699905794 | Genesis Rehab Services | Skilled Nursing Facility | 35 Marc Dr, Wallingford, CT 06492-5708 | 2009-07-23 |
| Find all providers in WALLINGFORD | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
Please comment or provide details below to improve the information on MASONICARE HEALTH CENTER.
| 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.