Active NPI
Pomperaug Woods, Inc.
Doing business as Pomperaug Woods Health Center
- Skilled Nursing Facility
- Southbury, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2033-C
- Legal business name
- POMPERAUG WOODS, INC.
- Doing business as
- Pomperaug Woods Health Center
- Practice address
- 80 Heritage Rd
Southbury, CT 06488-3851 - Phone
- (203) 262-6555
- Fax
- (203) 264-2155
- NPI assigned
- Dec 2, 2005
- Last updated
- Aug 28, 2019
- 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
- William B Neil Jr.
- Title
- President
- Phone
- (203) 262-6555
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2033-C | CT | Primary |
Addresses
Primary practice location
80 Heritage Rd
Southbury, CT 06488-3851
Mailing address
80 Heritage Rd
Southbury, CT 06488-1882
Phone (203) 262-6555
Other names 1
- Pomperaug Woods Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070828000218 | CT | Part A Provider - Skilled Nursing Facility | 1456443035 | Practice locations: Southbury, CT |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1154305290. Details of each certification follow.
Skilled nursing facility certification: CCN 075318
- Legal name
- POMPERAUG WOODS INC
- Doing business as
- POMPERAUG WOODS HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- May 18, 1988
- Last certification
- Oct 16, 2024
- Beds
- 37
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 80 Heritage Rd
Southbury, CT 06488-1882 - Nursing home name
- POMPERAUG WOODS HEALTH CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pomperaug Woods Health Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- Non profit - Corporation
- Certified
- May 18, 1988
- Medicare certification status
- Active
- Certified beds
- 37
- Penalties (3 years)
- 2
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 |
|---|---|---|---|
| 07D0700771 | Pomperaug Woods Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 12
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 |
|---|---|---|---|
| Vicki Gyba | Operational/Managerial Control | Jun 24, 2024 | |
| Adp of the SNF | Mar 20, 2025 | ||
| Marc N Raad | Operational/Managerial Control | Jul 1, 2021 | |
| Adp of the SNF | Mar 31, 2025 | ||
| Mary E Wnuck | Corporate Officer | Jan 25, 2021 | |
| Corporate Director | Feb 7, 2017 | ||
| Jane C. Connery | Corporate Officer | Jan 25, 2021 | |
| Corporate Director | Jan 1, 2012 | ||
| Patrick Monahan | Corporate Director | Oct 1, 2023 | |
| Newtown Savings Bank | 5% Or Greater Mortgage Interest | Jun 5, 2020 | 8% |
| 5% Or Greater Security Interest | Jun 5, 2020 | 8% | |
| Greg Lukos | Corporate Officer | Feb 1, 2024 | |
| Corporate Director | Feb 1, 2024 | ||
| Matthew Mihalcik | Corporate Officer | Jan 1, 2025 | |
| Corporate Director | Dec 1, 2018 | ||
| Karen F Schwarzchild | Corporate Director | Feb 1, 2024 | |
| Christine Edelson | Corporate Director | Mar 1, 2022 | |
| Antonio Vas | Corporate Director | May 1, 2021 | |
| Helena M Jedlinsky | Corporate Director | Dec 10, 2019 |
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
- Wolcott, CT
- NPI 1316085665
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
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": "1133481600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566950400000",
"number": "1154305290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 HERITAGE RD",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "064881882",
"telephone_number": "203-262-6555",
"fax_number": "203-264-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 HERITAGE RD",
"city": "SOUTHBURY",
"state": "CT",
"postal_code": "064883851",
"telephone_number": "203-262-6555",
"fax_number": "203-264-2155"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POMPERAUG WOODS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-02",
"last_updated": "2019-08-28",
"status": "A",
"authorized_official_last_name": "NEIL",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "203-262-6555",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CT",
"license": "2033-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Pomperaug Woods Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Southbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.