Active NPI
Senior Residential Care - Kingston, Inc.
- Skilled Nursing Facility
- Kingston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0931
- Legal business name
- SENIOR RESIDENTIAL CARE - KINGSTON, INC.
- Practice address
- 17 Chipman Way
Kingston, MA 02364-1039 - Phone
- (781) 585-4100
- Fax
- (781) 585-1651
- NPI assigned
- May 9, 2006
- 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
- Ms. Tamilyn M. Levin, ESQ.
- Title
- Cfo
- Phone
- (781) 707-9510
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | MA | ||
| Skilled Nursing Facility | 314000000X | 0931 | MA | Primary |
Addresses
Primary practice location
17 Chipman Way
Kingston, MA 02364-1039
Mailing address
63 Kendrick St
Needham, MA 02494-2708
Phone (781) 707-9085
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1906119 | Medicaid | MA | |
| 110026630C | Medicaid | MA | |
| 0928160 | Medicaid | MA | |
| 110026630A | Medicaid | MA |
Other names 1
- Wingate at Silver Lake Rehab. & Skilled Nsg. Residence
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060417000758 | MA | Part A Provider - Skilled Nursing Facility | 2860401072 | Practice locations: Kingston, MA |
Skilled nursing facility certification: CCN 225544
- Legal name
- SENIOR RESIDENTIAL CARE - KINGSTON, INC.
- Doing business as
- WINGATE AT SILVER LAKE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1992
- Last certification
- Mar 25, 2025
- Beds
- 164
- Ownership / control type
- Individual
- Multi-facility organization
- Wingate Living
- Most recent change of ownership
- Jul 24, 2002
- Organization structure
- Corporation
- Incorporated
- Feb 1, 1992 in MA
- Enrollment address
- 17 Chipman Way
Kingston, MA 02364-1039 - Nursing home name
- WINGATE AT SILVER LAKE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Wingate at Silver Lake
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 1, 1992
- Medicare certification status
- Active
- Certified beds
- 164
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0865066 | Wingate at Silver Lake Rehabilitative & Skilled | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 8
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 |
|---|---|---|---|
| Jonathan Scharf | Corporate Officer | Oct 1, 2017 | |
| Scott C Schuster | 5% Or Greater Direct Ownership Interest | Jul 16, 2002 | 100% |
| Corporate Officer | Aug 8, 2001 | 100% | |
| Corporate Director | Aug 8, 2001 | 100% | |
| Operational/Managerial Control | Aug 8, 2001 | ||
| Managing Control - Governing Body | Aug 8, 2001 | ||
| Christopher Stack | Corporate Officer | Jan 1, 2025 | 100% |
| Adp of the SNF | Jan 1, 2025 | ||
| Stephanie L Groll | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Alexandra Schuster | Corporate Officer | Jan 1, 2025 | 100% |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Gregory Logan | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | May 9, 2025 | ||
| John D Diorio | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Brian Swartz | Corporate Officer | Jan 1, 2025 | 100% |
| Adp of the SNF | Jan 1, 2025 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Abington, MA
- NPI 1932131000
Adp of the SNF, Operational/Managerial Control
-
- Geriatric Medicine (Family Medicine) Physician
- Marshfield, MA
- NPI 1932147444
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Abington, MA
- NPI 1932131000
-
- Geriatric Medicine (Family Medicine) Physician
- Marshfield, MA
- NPI 1932147444
-
- Internal Medicine Physician
- Pembroke, MA
- NPI 1043284789
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Marshfield, MA
- NPI 1932147444
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1349395200000",
"number": "1144279712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 KENDRICK ST",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "024942708",
"telephone_number": "781-707-9085",
"fax_number": "781-707-9285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 CHIPMAN WAY",
"city": "KINGSTON",
"state": "MA",
"postal_code": "023641039",
"telephone_number": "781-585-4100",
"fax_number": "781-585-1651"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR RESIDENTIAL CARE - KINGSTON, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-09",
"last_updated": "2012-10-05",
"status": "A",
"authorized_official_last_name": "LEVIN",
"authorized_official_first_name": "TAMILYN",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "781-707-9510",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "ESQ."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MA",
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "0931",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1906119",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026630C",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0928160",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026630A",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Wingate at Silver Lake Rehab. & Skilled Nsg. Residence",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kingston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.