St. Mary's Villa Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

711502 Issued in PA

Legal business name

ST. MARY'S VILLA NURSING HOME, INC.

Practice address

516 Saint Marys Villa Rd
Elmhurst Township, PA 18444-9683

Phone

(570) 842-7621

Fax

(570) 842-2953

NPI assigned

May 31, 2005

Last updated

Nov 19, 2014By 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

Linda Kanarr, NHA

Title

Ceo

Phone

(570) 842-7621

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104829571. Details of each certification follow.

• CCN 395104 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 395104

Legal name

ST. MARY'S VILLA NURSING HOME, INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1977

Last certification

Nov 15, 2024

Beds

112

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Covenant Health

Organization structure

CorporationNon-profit

Incorporated

Jul 16, 1975 in PA

Enrollment address

516 Saint Marys Villa Rd
Elmhurst Township, PA 18444-9614

Nursing home name

SAINT MARY'S VILLA NURSING HOM

Affiliated entity

COVENANT HEALTH

Listed as

Saint Mary's Villa Nursing HomCCN 395104 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11293.9 residents per day on average

Chain

Covenant Health8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 5

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.

• Samuel A Valenti, M.D.

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1609979988

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 2

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.

• Kenneth J Sebastianelli, MD

  • Internal Medicine Physician
  • Moosic, PA
  • NPI 1679543110
  NPD (past)
• Samuel A Valenti, M.D.

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1609979988
  NPD (past)

Affiliated clinicians 2

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

• Kenneth J Sebastianelli, MD

  • Internal Medicine Physician
  • Moosic, PA
  • NPI 1679543110

  Nursing home

  Care Compare affiliation
• Samuel A Valenti, M.D.

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1609979988

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1104829571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SAINT MARYS VILLA RD",
            "city": "ELMHURST TOWNSHIP",
            "state": "PA",
            "postal_code": "184449683",
            "telephone_number": "570-842-7621",
            "fax_number": "570-842-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SAINT MARYS VILLA RD",
            "city": "ELMHURST TOWNSHIP",
            "state": "PA",
            "postal_code": "184449683",
            "telephone_number": "570-842-7621",
            "fax_number": "570-842-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S VILLA NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "KANARR",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-842-7621",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "711502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0754940",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly A. Desau, MS, OTR/L
• Jeffrey Daniel Kramer

• Skilled Nursing Facility in Elmhurst Township, PA
• Providers in Elmhurst Township, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.