St. Ann's Home for the Aged

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2757300N Issued in NY

Legal business name

ST. ANN'S HOME FOR THE AGED

Practice address

1500 Portland Avenue
Rochester, NY 14621

Phone

(585) 697-6337

Fax

(585) 544-4226

NPI assigned

Jul 2, 2006

Last updated

Jun 10, 2022By 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

Dennis Kant

Title

Cfo

Phone

(585) 697-6307

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225067168. Details of each certification follow.

• CCN 335081001 Skilled nursing facility · Details

Skilled nursing facility certification: CCN 335081001

Legal name

ST ANNS HOME FOR THE AGED

Organization structure

CorporationNon-profit

Enrollment address

1500 Portland Ave
Rochester, NY 14621-3065

Nursing home name

ST. ANN'S COMMUNITY

Other NPIs with the same Medicare PAC ID 1

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

• St Anns Home for the Aged

  dba St Anns Home Pharmacy

  • Long Term Care Pharmacy
  • Rochester, NY
  • NPI 1871698738

  5092758938

  Same PAC ID

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

CLIA laboratory certificates

All disclosed owners & managing parties 27

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 2

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

• Kim K Petrone, MD

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1518946599

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Bridgette Ann Wiefling, M.D.

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1265545693

  Adp of the SNF, Managing Control - Governing Body

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• St Ann's Social Adult Day Services at Durand

  • Adult Day Care Clinic/Center
  • Rochester, NY
  • NPI 1376411405
  NPPES parent name

Practitioners 14

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.

• Rebecca Anne Carney, PT, DPT

  • Physical Therapist
  • Rochester, NY
  • NPI 1669769238
  Medicare reassignment Care Compare group NPD
• Rebecca Conklin, D.O.

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1437545936
  Medicare reassignment Care Compare group NPD
• Brian Dewayne Day, D.O.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1457580532
  Medicare reassignment Care Compare group NPD
• Christopher Gise, PA-C

  • Physician Assistant
  • Rochester, NY
  • NPI 1831529304
  Medicare reassignment Care Compare group NPD
• Rachel Renee Holmes, NP

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1518421510
  Medicare reassignment Care Compare group NPD
• Kim K Petrone, MD

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1518946599
  Medicare reassignment Care Compare group NPD
• Taylor Ross

  • Occupational Therapist
  • Rochester, NY
  • NPI 1144700113
  Medicare reassignment Care Compare group NPD
• Rachel Ann Salisbury, AGPCNP

  • Adult Health Nurse Practitioner
  • Rochester, NY
  • NPI 1265918395
  Medicare reassignment Care Compare group NPD
• Krupa Shah, M.D.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1609978253
  Medicare reassignment Care Compare group NPD
• Marianne Valenzuela, FNP

  • Family Nurse Practitioner
  • Binghamton, NY
  • NPI 1538541925
  Medicare reassignment Care Compare group NPD
• Erin Ward, FNP

  • Family Nurse Practitioner
  • Rochester, NY
  • NPI 1073878310
  Medicare reassignment Care Compare group NPD
• Rebecca Abrey, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Rochester, NY
  • NPI 1508428830
  Medicare reassignment NPD

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1225067168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-697-6337",
            "fax_number": "585-544-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PORTLAND AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-697-6337",
            "fax_number": "585-544-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANN'S HOME FOR THE AGED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "KANT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-697-6307"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "2757300N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02994787",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "353806",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine St John
• St Johns Health Care Corporation (St. John's Home)
• St Johns Health Care Corporation (St Johns Health Care Corp)
• St Josephs Neighborhood Center Inc
• Kayla Dona St Lucia, DO
• Erin St. George
• Eleanor Pope St. John
• Robin D St. John, LPN
• Thomas St. John Jr.
• St. John's Nursing Home Non Occ

• Skilled Nursing Facility in Rochester, NY
• Providers in Rochester, 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 Jun 10, 2022; 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.