Providence Rest

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7000306N Issued in NY

Legal business name

PROVIDENCE REST

Practice address

3304 Waterbury Ave
Bronx, NY 10465-1554

Phone

(718) 931-3000

Fax

(718) 514-8447

NPI assigned

Jul 19, 2005

Last updated

Jul 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan M Steinberg, LNHA

Title

Administrator

Phone

(718) 931-3000

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063411262. Details of each certification follow.

• CCN 335583 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 335583

Legal name

PROVIDENCE REST

Doing business as

ARCHCARE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1976

Last certification

Mar 7, 2025

Beds

200

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Archcare

Organization structure

CorporationNon-profit

Enrollment address

3304 Waterbury Ave
Bronx, NY 10465-1554

Nursing home name

ARCHCARE AT PROVIDENCE REST

Affiliated entity

ARCHCARE

Listed as

Archcare at Providence RestCCN 335583 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 1, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

200189.4 residents per day on average

Chain

Archcare7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Providence Rest Adult Day Health Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Rest Adult Day Health Care

  • Adult Day Care Clinic/Center
  • Bronx, NY
  • NPI 1063597631
  NPD tax ID
• Providence Rest Outpatient Rehabilitation

  • Skilled Nursing Facility
  • Bronx, NY
  • NPI 1871754861
  NPD tax ID
• Savanna V Wilson

  • Local Education Agency (LEA)
  • Bronx, NY
  • NPI 1679813596
  NPD tax ID

All disclosed owners & managing parties 28

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Hammad Rizvi, D.O.

  • Internal Medicine Physician
  • New York, NY
  • NPI 1659516227

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Calvary Hospital Inc

  • Special Hospital
  • Bronx, NY
  • NPI 1003858390

  Catholic Health Care Systems

  CMS ownership
• Calvary Hospital Inc.

  dba Calvary Hospital Hospice

  • Community Based Hospice Care Agency
  • Bronx, NY
  • NPI 1396756524

  Catholic Health Care Systems

  CMS ownership
• Carmel Richmond Nursing Home, Inc.

  dba Carmel Richmond Health Care and Rehabilitation Center

  • Skilled Nursing Facility
  • Staten Island, NY
  • NPI 1023097698

  Catholic Health Care Systems

  CMS ownership
• Ferncliff Nursing Home Company, Inc.

  • Skilled Nursing Facility
  • Rhinebeck, NY
  • NPI 1083693576

  Catholic Health Care Systems

  CMS ownership
• St Vincent de Paul Residence

  • Skilled Nursing Facility
  • Bronx, NY
  • NPI 1053390534

  Catholic Health Care Systems

  CMS ownership
• Terence Cardinal Cooke Health Care Center

  • Skilled Nursing Facility
  • New York, NY
  • NPI 1598744146

  Catholic Health Care Systems

  CMS ownership

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Robert Avanzato, D.O

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1336354778
  NPD (past)
• Paul Michael Bisson, M.D

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1649484163
  NPD (past)
• Jean Louise Harris, D.O.

  • Family Medicine Physician
  • Bronx, NY
  • NPI 1811162480
  NPD (past)
• Win Myint, M.D

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1861460818
  NPD (past)
• Cynthia Sudar Singh Prabahar, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1114064425
  NPD (past)
• Badri D Taparia, M.D..

  • General Practice Physician
  • Bronx, NY
  • NPI 1902944408
  NPD (past)

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Anthony Robert Avanzato, D.O

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1336354778

  Nursing home

  Care Compare affiliation
• Paul Michael Bisson, M.D

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1649484163

  Nursing home

  Care Compare affiliation
• Win Myint, M.D

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1861460818

  Nursing home

  Care Compare affiliation
• Cynthia Sudar Singh Prabahar, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1114064425

  Nursing home

  Care Compare affiliation
• Badri D Taparia, M.D..

  • General Practice Physician
  • Bronx, NY
  • NPI 1902944408

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1063411262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000",
            "fax_number": "718-514-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651554",
            "telephone_number": "718-931-3000",
            "fax_number": "718-514-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE REST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "STEINBERG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-931-3000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7000306N",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NY",
            "license": "7000306N",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "007381",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00309357",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01133297",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY",
            "identifier": "1216",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deshanna Prosper, LCSW
• Gerard Guy Prosper, MD
• Protherapy Rehabilitation OT, PT, SLP, PLLC
• Prothotics Technology Inc (Prothotics Health)
• Maria Provenznao, LCSW
• Providence Rest Adult Day Health Care
• Providence Rest Outpatient Rehabilitation
• Keisha Janine Providence, FNP
• Provident Pharma LLC (Morris Ave Pharmacy)
• Winnie Province, RN

• Skilled Nursing Facility in Bronx, NY
• Providers in Bronx, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.

Verify at the official NPI Registry.