Active NPI
Oc Azure of Worcester Center LLC
- Skilled Nursing Facility
- Worcester, MA
National Provider Identifier
1053072231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- OC AZURE OF WORCESTER CENTER LLC
- Practice address
- 25 Oriol Dr
Worcester, MA 01605-1911 - Phone
- (508) 852-3330
- NPI assigned
- Jan 10, 2022
- 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
- Eliyahu Mirlis
- Title
- Owner
- Phone
- (732) 961-8491
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
25 Oriol Dr
Worcester, MA 01605-1911
Mailing address
25 Oriol Dr
Worcester, MA 01605-1911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220309002921 | MA | Part A Provider - Skilled Nursing Facility | 1850786880 | Practice locations: Worcester, MA |
Skilled nursing facility certification: CCN 225467
- Legal name
- OC AZURE OF WORCESTER CENTER LLC
- Doing business as
- REGAL CARE AT WORCESTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1990
- Last certification
- Jan 4, 2024
- Beds
- 160
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Regalcare Management
- Organization structure
- LLC
- Enrollment address
- 25 Oriol Dr
Worcester, MA 01605-1911 - Nursing home name
- REGALCARE AT WORCESTER
- Affiliated entity
- REGALCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Regalcare at Worcester
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1990
- Medicare certification status
- Active
- Certified beds
- 160
- Chain
- Regalcare
National Provider Directory
National Provider DirectoryOwnership & 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 |
|---|---|---|---|
| Eliyahu Mirlis | 5% Or Greater Indirect Ownership Interest | Feb 1, 2022 | 100% |
| Corporate Officer | Feb 1, 2022 | ||
| W-2 Managing Employee | Feb 1, 2022 | ||
| Oc Azure of Worcester Holdings LLC | 5% Or Greater Direct Ownership Interest | Feb 1, 2022 | 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.
-
- Internal Medicine Physician
- Westborough, MA
- NPI 1932113446
-
- Internal Medicine Physician
- Melrose, MA
- NPI 1588683494
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641772800000",
"number": "1053072231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 ORIOL DR",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ORIOL DR",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016051911",
"telephone_number": "508-852-3330"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OC AZURE OF WORCESTER CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-10",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A",
"authorized_official_last_name": "MIRLIS",
"authorized_official_first_name": "ELIYAHU",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "732-961-8491"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.