NPIMap

Organization Active NPI

Nazareth Hospital

  • Skilled Nursing Facility
  • Philadelphia, PA
National Provider Identifier
1083611487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
400302 Issued in PA
Legal business name
NAZARETH HOSPITAL
Practice address
2601 Holme Ave
Philadelphia, PA 19152-2007
Phone
(215) 335-6000
Fax
(215) 335-6303
NPI assigned
Jun 30, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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. David A. Wajda
Title
Chief Financial Officer, VP Finance
Phone
(215) 335-6043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 400302 PA Primary

Addresses

Primary practice location

2601 Holme Ave
Philadelphia, PA 19152-2007

Mailing address

2601 Holme Ave
Philadelphia, PA 19152-2007
Phone (215) 335-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110119000987 PA Part A Provider - Skilled Nursing Facility 1951202910 Practice locations: Philadelphia, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083611487. Details of each certification follow.

Skilled nursing facility certification: CCN 396002

Legal name
NAZARETH HOSPITAL
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Aug 2, 1996
Last certification
Mar 20, 2025
Beds
28
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Trinity Health
Organization structure
CorporationNon-profit
Incorporated
Nov 15, 1994 in PA
Enrollment address
2601 Holme Ave
Transition Care Unit
Philadelphia, PA 19152-2007
Nursing home name
TRANSITIONAL CARE UNIT AT NAZARETH HOSPITAL
Affiliated entity
TRINITY HEALTH

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Transitional Care Unit at Nazareth HospitalCCN 396002 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Aug 2, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2814.7 residents per day on average
Chain
Trinity Health19 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
NH House Physiciansnaz8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Marianne Grace Individual Corporate DirectorBoard Member Aug 1, 2022
James M Monihan Individual Corporate DirectorBoard Member Jan 1, 2022
Martina Deignan Individual Corporate DirectorBoard Member Jan 1, 2022
Rebecca Johnson Individual Corporate DirectorBoard Member Jan 1, 2022
Talyana Bromberg Individual Corporate DirectorBoard Member Jul 1, 2019
Julie Washington Individual Corporate DirectorBoard Member Jan 1, 2022
Barbara Buckley Individual Corporate DirectorBoard Member Jan 1, 2022
James L. Woodward Individual Corporate OfficerPresident Jul 1, 2019
Corporate DirectorBoard Member Jul 1, 2019
David a Wajda Individual W-2 Managing EmployeeDirector Offinance Jan 1, 2022
Julia Keegan Individual Corporate DirectorBoard Member Jan 1, 2023
Hiral P Fontanilla Individual Corporate DirectorBoard Member Jan 1, 2022
Michelle Calope Individual Corporate DirectorBoard Member Jan 1, 2023
Michael a Magro Individual Corporate OfficerPresident Jun 24, 2021
Shaila Kapur Individual Corporate OfficerVice Chair Jan 1, 2024
Corporate DirectorBoard Member Jan 1, 2022
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2019 100%
Stuart Kilpinen Individual Operational/Managerial ControlChain Home Office Administrator Jun 10, 2023
Trinity Health of the Mid-Atlantic Region Organization, Newtown Square, PA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2013 100%
Vincent D Gordon Individual Corporate OfficerChair Jan 1, 2024
Corporate DirectorBoard Member Aug 1, 2022
Catherine Mikus Individual Corporate OfficerSecretary Jul 1, 2021
Mark D Brucker Individual Corporate DirectorBoard Member Jan 1, 2022
Kimberly Cummings Individual Corporate OfficerTreasurer and Interim Cfo Jan 1, 2023

Owners & managing parties with NPI records 2

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

Facilities with the same owner 158

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

View all 158

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 2

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": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083611487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6000",
            "fax_number": "215-335-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6000",
            "fax_number": "215-335-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAZARETH HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAJDA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER, VP FINANCE",
        "authorized_official_telephone_number": "215-335-6043",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "400302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.