JEWISH HOME FOR AGED (NPI# 1154318335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154318335 |
| Entity Type | Organization |
| Organization Name | JEWISH HOME FOR AGED |
| Practice Address |
169 Davenport Ave New Haven CT 06519 |
| Practice Telephone | 2037891650 |
| Practice Fax Number | 2037870071 |
| Mailing Telephone | 2037891650 |
| Mailing Fax Number | 2037870071 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2008-08-14 |
| Authorized Official Name | SUZANNE MARIE BOUSQUET (CFO) |
| Authorized Official Telephone | 7037891650 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 32-C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | EVERCARE HMO | 71-01006 | 01 |
| CT | 000000323 | 05 | |
| CT | ANTHEM BC/BS OF CT | 706 | 01 |
| Street Address |
169 DAVENPORT AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184221970 | Scott Andrew Witter | Social Worker | 169 Davenport Ave, New Haven, CT 06519-1319 | 2020-10-05 |
| 1336599497 | Advanced Center for Nursing & Rehabilitation LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2016-06-20 |
| 1740561489 | Jha Health Care, Inc. | Clinic/Center | 169 Davenport Ave, New Haven, CT 06519-1319 | 2011-09-08 |
| 1285939041 | Advanced Nursing & Rehabilitation Center of New Haven LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2011-01-25 |
| 1871535237 | Anitha Pothula | Internal Medicine | 169 Davenport Ave, New Haven, CT 06519-1319 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
| Find all providers in zip 06519 | ||||
| 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. |
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| 1174622278 | Pratt's Rexall Drugs, Inc | Skilled Nursing Facility | 100 Dwayne Von Behren Dr, New Haven, MO 63068-3207 | 2006-09-22 |
| 1912930223 | Adams County Memorial Hospital | Skilled Nursing Facility | 1201 Daly Dr, New Haven, IN 46774 | 2006-07-09 |
| 1255379517 | Marathon Healthcare Center of New Haven LLC | Skilled Nursing Facility | 181 Clifton St, New Haven, CT 06513-3319 | 2006-06-02 |
| 1629053079 | Leeway, Inc | Skilled Nursing Facility | 40 Albert St, New Haven, CT 06511-1542 | 2005-12-08 |
| 1760479125 | New Haven Care Center, Inc | Skilled Nursing Facility | 9503 Highway 100, New Haven, MO 63068-1300 | 2005-09-30 |
| 1043207723 | Haven Health Center of New Haven, LLC | Skilled Nursing Facility | 915 Ella T Grasso Blvd, New Haven, CT 06519-5516 | 2005-09-29 |
| 1336599497 | Advanced Center for Nursing & Rehabilitation LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2016-06-20 |
| 1467715755 | Yale-new Haven Care Continuum Corporation | Skilled Nursing Facility | 1354 Chapel St, New Haven, CT 06511-4420 | 2012-06-21 |
| 1285939041 | Advanced Nursing & Rehabilitation Center of New Haven LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2011-01-25 |
| 1376777698 | Paradigm Healthcare Center of New Haven, LLC | Skilled Nursing Facility | 181 Clifton St, New Haven, CT 06513-3319 | 2009-05-14 |
| Find all providers in NEW HAVEN | ||||
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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.