SRC MELROSE, LLC (NPI# 1073987558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073987558 |
| Entity Type | Organization |
| Organization Name | SRC MELROSE, LLC |
| Practice Address |
15 Green St Melrose MA 02176-2811 |
| Mailing Address |
63 Kendrick St Needham MA 02494-2708 |
| Practice Telephone | 7816653950 |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |
| Authorized Official Name | TAMILYN LEVIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7817079510 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SRC MELROSE, LLC | 63 Kendrick Street, Needham, MA 02494 |
| Street Address |
15 GREEN ST |
| City | MELROSE |
| State | MA |
| Zip Code | 02176-2811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093739583 | Jacs Ops I Inc | Skilled Nursing Facility | 15 Green St, Melrose, MA 02176 | 2006-07-27 |
| 1255652244 | Kirsten Peltz | Speech-Language Pathologist | 15 Green St, Wingate At Melrose, Melrose, MA 02176-2811 | 2010-06-14 |
| 1700066487 | Epoch Senior Healthcare of Melrose, LLC | Skilled Nursing Facility | 15 Green St, Melrose, MA 02176-2811 | 2007-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384826 | Edrine Astremont | Registered Nurse | 414 Malden, Massachusetts, NY 02176 | 2020-07-23 |
| 1194203919 | Caroline Bregman | Social Worker | 12 Howard St, Melrose, MA 02176 | 2018-08-02 |
| 1386167682 | Carmen Alicia Fernandez | Community/Behavioral Health | 24 Lynde St, Melrose, MA 02176 | 2017-07-19 |
| 1518316116 | Sheila Kelley | Physical Therapist | 15 Green Street, Melrose, MA 02176 | 2016-06-06 |
| 1083049712 | Randi A Brown | Counselor | 610 A Main Street, Melrose, MA 02176 | 2013-09-12 |
| 1306121488 | Frank Anthony Pennacchio | Pharmacist | 17 Coolidge Road, Melrose, MA 02176 | 2011-10-20 |
| 1245401751 | Meaghan Rudolph | Registered Nurse | 11 Stratford Rd, Melrose, MA 02176 | 2008-03-13 |
| 1104039726 | Judy E Bushee | Custodial Care Facility | The Toole Nursing Home, 92 Franklin Street, Melrose, MA 02176 | 2007-05-08 |
| 1811012776 | Mark Joseph Gianatassio | Dentist | 820 Lynn Fells, Melrose, MA 02176 | 2007-03-20 |
| 1154452993 | City of Melrose | Local Education Agency (LEA) | 360 Lynn Fells Parkway, Melrose, MA 02176 | 2007-03-07 |
| Find all providers in zip 02176 | ||||
| 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 |
|---|---|---|---|---|
| 1093739583 | Jacs Ops I Inc | Skilled Nursing Facility | 15 Green St, Melrose, MA 02176 | 2006-07-27 |
| 1831141704 | Ggnsc Melrose Center LLC | Skilled Nursing Facility | 40 Martin St, Melrose, MA 02176-3607 | 2006-05-17 |
| 1124016159 | Tuell Nursing Home Inc. | Skilled Nursing Facility | 92 Franklin St, Melrose, MA 02176-1821 | 2005-10-13 |
| 1336678630 | 40 Martin Street Operator LLC | Skilled Nursing Facility | 40 Martin St, Melrose, MA 02176-3607 | 2017-06-08 |
| 1194254565 | 743 Main Street Operator LLC | Skilled Nursing Facility | 743 Main St, Melrose, MA 02176-2707 | 2017-06-08 |
| 1508316670 | Redwood Acquisition East LLC | Skilled Nursing Facility | 743 Main St, Melrose, MA 02176-2707 | 2016-10-12 |
| 1124578398 | Redwood Acquisition West LLC | Skilled Nursing Facility | 40 Martin St, Melrose, MA 02176-3607 | 2016-10-11 |
| 1700066487 | Epoch Senior Healthcare of Melrose, LLC | Skilled Nursing Facility | 15 Green St, Melrose, MA 02176-2811 | 2007-11-09 |
| 1083666960 | Ggnsc Melrose Elmhurst LLC | Skilled Nursing Facility | 743 Main St, Melrose, MA 02176-2707 | 2006-05-17 |
| 1366400822 | Centracare Health System - Melrose | Skilled Nursing Facility | 525 Main St W, Melrose, MN 56352-1043 | 2006-05-03 |
| Find all providers in MELROSE | ||||
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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.