NPIMap

Organization Active NPI

Bear Mt Sudbury LLC

  • Skilled Nursing Facility
  • Sudbury, MA
National Provider Identifier
1265992903
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BEAR MT SUDBURY LLC
Practice address
136 Boston Post Rd
Sudbury, MA 01776-2406
Phone
(978) 443-2722
NPI assigned
Mar 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Wynne Jr.
Title
Member/Cfo
Phone
(860) 880-8202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

136 Boston Post Rd
Sudbury, MA 01776-2406

Mailing address

130 S Main St Ste 203
Thomaston, CT 06787-1741
Phone (860) 880-8202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191127001808 MA Part A Provider - Skilled Nursing Facility 9234562570 Practice locations: Sudbury, MA

Skilled nursing facility certification: CCN 225710

Legal name
BEAR MT SUDBURY LLC
Doing business as
BEAR MOUNTAIN AT SUDBURY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 26, 1996
Last certification
Nov 5, 2024
Beds
142
Ownership / control type
Corporation
Multi-facility organization
Bear Mountain
Organization structure
LLCProprietary
Incorporated
Mar 12, 2019 in MA
Enrollment address
136 Boston Post Rd
Sudbury, MA 01776-2406
Nursing home name
VANTAGE AT SUDBURY LLC
Affiliated entity
VANTAGE CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vantage at Sudbury LLCCCN 225710 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 26, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14266.6 residents per day on average
Chain
Vantage Care10 facilities in the chain
Penalties (3 years)
1Fines totaling $15,672

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0916325Bear Mt Sudbury LLC136 Boston Post Rd, Sudbury, MA 01776Certificate of waiverJun 19, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Jeri Ann Johnson Individual Operational/Managerial Control Sep 23, 2024
Managing Control - Governing BodyVP of Operations Sep 23, 2024
Adp of the SNF Oct 16, 2023
Sabra Health Care Reit Inc Organization, Tustin, CA Corporation Adp of the SNF Sep 29, 2025
Scott L Ziskin Individual 5% Or Greater Indirect Ownership InterestPresident & Ceo Nov 21, 2019 50%
Zachary Goldman Individual Operational/Managerial Control Apr 1, 2024
Adp of the SNF Apr 1, 2024
Innovations Healthcare, LLC Organization, Pascoag, RI LLC Operational/Managerial Control Mar 20, 2025
Adp of the SNF Oct 27, 2025
Donna Orchard Individual Operational/Managerial Control Sep 13, 2021
Adp of the SNF Sep 13, 2021
Avi Rosenbloom Individual Operational/Managerial Control Sep 23, 2024
Managing Control - Governing BodyRe. Director of Operations Sep 23, 2024
Adp of the SNF Sep 23, 2024
Individual Adp of the SNF Mar 20, 2025
Organization, Lakewood, NJ LLC Adp of the SNF Sep 29, 2025
Morris Green Individual Operational/Managerial Control Sep 23, 2024
Adp of the SNF Apr 8, 2024
Organization, Tustin, CA Adp of the SNF Nov 23, 2019
Bear Mountain Healthcare LLC Organization, Thomaston, CT LLC, For-profit 5% Or Greater Direct Ownership Interest Nov 21, 2019 100%
Michael Kaplan Individual 5% Or Greater Indirect Ownership InterestCeo Nov 21, 2019 50%
Michael Flanagan Individual Operational/Managerial Control Sep 23, 2024
Ajay J Anand Individual Operational/Managerial Control Dec 10, 2021
Adp of the SNF Dec 10, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1265992903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST STE 203",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871741",
            "telephone_number": "860-880-8202",
            "fax_number": "860-880-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BOSTON POST RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017762406",
            "telephone_number": "978-443-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR MT SUDBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER/CFO",
        "authorized_official_telephone_number": "860-880-8202",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

Verify at the official NPI Registry.