Organization Active NPI

Bridgeport Health Care Center, Inc

  • Skilled Nursing Facility
  • Bridgeport, CT
National Provider Identifier
1003909623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2079-C Issued in CT
Legal business name
BRIDGEPORT HEALTH CARE CENTER, INC
Practice address
540 Bond Street
Bridgeport, CT 06610
Phone
(203) 384-6400
Fax
(203) 384-6499
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Christopher A Massaro, LNHA
Title
Administrator
Phone
(203) 384-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2079-C CT Primary

Addresses

Primary practice location

540 Bond Street
Bridgeport, CT 06610

Mailing address

540 Bond Street
Bridgeport, CT 06610
Phone (203) 384-6400

Other identifiers 1

IdentifierTypeStateIssuer
9000020793MedicaidCT

Other names 1

  • Bridgeport Manor Doing business as

National Provider Directory

National Provider Directory

Locations

540 Bond St
Bridgeport, CT 06610
Phone (203) 384-6400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003909623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 BOND STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-384-6400",
            "fax_number": "203-384-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BOND STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-384-6400",
            "fax_number": "203-384-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT HEALTH CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASSARO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-384-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2079-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000020793",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.