Active NPI
Market Square Health Care Center, LLC
- Skilled Nursing Facility
- South Paris, ME
National Provider Identifier
1003239179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2625
- Legal business name
- MARKET SQUARE HEALTH CARE CENTER, LLC
- Practice address
- 3 Market SQ
South Paris, ME 04281-1114 - Phone
- (207) 743-7086
- Fax
- (207) 743-2395
- NPI assigned
- Jan 27, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Glen G Cyr
- Title
- Senior VP of Finance
- Phone
- (207) 786-3554
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2625 | ME | Primary |
Addresses
Primary practice location
3 Market SQ
South Paris, ME 04281-1114
Mailing address
179 Lisbon St Ste 2
P.O. Box 1408
Lewiston, ME 04240-7248
Phone (207) 786-3554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140523000956 | ME | Part A Provider - Skilled Nursing Facility | 4486877271 | Practice locations: South Paris, ME |
Skilled nursing facility certification: CCN 205076
- Legal name
- MARKET SQUARE HEALTH CARE CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1992
- Last certification
- Mar 5, 2025
- Beds
- 76
- Ownership / control type
- Individual
- Most recent change of ownership
- Apr 1, 2014
- Organization structure
- LLC
- Incorporated
- Apr 1, 2014 in ME
- Enrollment address
- 3 Market St
South Paris, ME 04281-1559 - Nursing home name
- MARKET SQUARE HEALTH CARE CENTER, LLC
- Affiliated entity
- NORTH COUNTRY ASSOCIATES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Market Square Health Care Center, LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Apr 1, 1992
- Medicare certification status
- Active
- Certified beds
- 76
- Chain
- North Country Associates
National Provider Directory
National Provider Directory- Tax ID family
- Market Square Health Care Center LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- South Paris, ME
- NPI 1790820223
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Glen G Cyr | W-2 Managing Employee | Jan 1, 2008 | 40% |
| John C Orestis | 5% Or Greater Direct Ownership Interest | Nov 15, 2014 | 100% |
| Corporate Officer | Nov 15, 2014 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Portland, ME
- NPI 1508352410
-
- Geriatric Medicine (Internal Medicine) Physician
- Portland, ME
- NPI 1699868158
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Portland, ME
- NPI 1508352410
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1390780800000",
"number": "1003239179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 LISBON ST STE 2",
"address_2": "P.O. BOX 1408",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407248",
"telephone_number": "207-786-3554",
"fax_number": "207-786-8507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MARKET SQ",
"city": "SOUTH PARIS",
"state": "ME",
"postal_code": "042811114",
"telephone_number": "207-743-7086",
"fax_number": "207-743-2395"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARKET SQUARE HEALTH CARE CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-27",
"last_updated": "2014-01-27",
"status": "A",
"authorized_official_last_name": "CYR",
"authorized_official_first_name": "GLEN",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "SENIOR VP OF FINANCE",
"authorized_official_telephone_number": "207-786-3554",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "ME",
"license": "2625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Paris, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.