SOUTH COVE MANOR, INC (NPI# 1407859564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407859564 |
| Entity Type | Organization |
| Organization Name | SOUTH COVE MANOR, INC |
| Other Organization Name | SOUTH COVE MANOR |
| Practice Address |
120 Shawmut Avenue Boston MA 02118-2293 |
| Practice Telephone | 6174230590 |
| Practice Fax Number | 6172927922 |
| Mailing Telephone | 6174230590 |
| Mailing Fax Number | 6172927922 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-04-01 |
| Authorized Official Name | MR. RICHARD WONG (PRESIDENT / CEO) |
| Authorized Official Telephone | 6174230590 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0876 | MA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0916056 | 05 |
| Other Name | Type Code |
|---|---|
| South Cove Manor | Doing Business As Name - Organization |
| Street Address |
120 SHAWMUT AVENUE |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| 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 |
|---|---|---|---|---|
| 1174067052 | Companion Health Services | Skilled Nursing Facility | 284 North St, Boston, MA 02113-2108 | 2016-12-12 |
| 1487994893 | Jamaica Plain Health Group, LLC | Skilled Nursing Facility | 174 Forest Hill St, Boston, MA 02130-3353 | 2013-02-21 |
| 1376881201 | National Home Health Services Inc | Skilled Nursing Facility | 225 Franklin St Fl 26, Boston, MA 02110-2853 | 2013-01-28 |
| 1356496947 | Sherrill House, Inc | Skilled Nursing Facility | 135 S Huntington Ave, Boston, MA 02130-4885 | 2007-01-24 |
| 1962491704 | Edgar P Benjamin Healthcare Center, Inc | Skilled Nursing Facility | 120 Fisher Avenue, Boston, MA 02120-3320 | 2005-10-14 |
| 1407855000 | Frc, Inc | Skilled Nursing Facility | 70 Fulton St, Boston, MA 02109-1402 | 2005-07-18 |
| 1811990930 | Boston Home Inc | Skilled Nursing Facility | 2049 Dorchester Ave, Boston, MA 02124-4742 | 2005-05-23 |
| 1508386897 | Neb Operator LLC | Skilled Nursing Facility | 70 Fulton St, Boston, MA 02109-1402 | 2017-06-27 |
| 1891035283 | Brighton Health Group, LLC | Skilled Nursing Facility | 10 Bellamy St, Boston, MA 02135-1502 | 2013-02-21 |
| 1932320215 | Edgar P. Benjamin Healthcare Center, Inc | Skilled Nursing Facility | 120 Fisher Avenue, Boston, MA 02120-3320 | 2007-05-02 |
| Find all providers in BOSTON | ||||
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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.