Active NPI
Woburn Nursing Center, Inc
- Skilled Nursing Facility
- Woburn, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 4213
- Legal business name
- WOBURN NURSING CENTER, INC
- Practice address
- 18 Frances St
Woburn, MA 01801-3006 - Phone
- (781) 933-8175
- Fax
- (781) 729-3817
- NPI assigned
- Jun 10, 2005
- Last updated
- Aug 22, 2020
- 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
- Mr. Robert Driscoll
- Title
- Chief Operating Officer
- Phone
- (781) 994-2114
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 4213 | MA | Primary |
Addresses
Primary practice location
18 Frances St
Woburn, MA 01801-3006
Mailing address
18 Frances St
Woburn, MA 01801-3006
Phone (781) 933-8175
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 803059 | Other | MA | TUFTS/SECURE HORIZON |
| 0906905 | Medicaid | MA | |
| 903183 | Other | MA | HARVARD PILGRIM HEALTH |
| 2222539401 | Other | MA | BLUE CROSS BLUE SHIELD |
| 552468 | Other | MA | AETNA/ US HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120928000623 | MA | Part A Provider - Skilled Nursing Facility | 9638328065 | Practice locations: Woburn, MA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1285638890. Details of each certification follow.
Skilled nursing facility certification: CCN 225394
- Legal name
- WOBURN NURSING CENTER INC
- Doing business as
- WOBURN REHABILITATION & NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1990
- Last certification
- Jan 9, 2025
- Beds
- 140
- Ownership / control type
- Corporation
- Multi-facility organization
- Stellar Health Group
- Organization structure
- Corporation
- Incorporated
- Nov 9, 1966 in MA
- Enrollment address
- 18 Frances St
Woburn, MA 01801-3006 - Nursing home name
- WOBURN REHABILITATION AND NURSING CENTER
- Affiliated entity
- STELLAR HEALTH GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Woburn Rehabilitation and Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1990
- Medicare certification status
- Active
- Certified beds
- 140
- Chain
- Stellar Health Group
- Penalties (3 years)
- 1
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 |
|---|---|---|---|
| 22D0071163 | Woburn Nursing Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryLocations
18 Frances St
#3095
Woburn, MA 01801
Ownership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| Boston Master Tenant LLC | 5% Or Greater Indirect Ownership Interest | Dec 29, 2021 | 100% |
| Cheryl a Evangelista | W-2 Managing Employee | Sep 11, 2000 | |
| Robert Francis Driscoll | Corporate Officer | Aug 15, 2002 | |
| Barbara Johanson | W-2 Managing Employee | Jun 22, 1998 | |
| Ariel T Erlichman | 5% Or Greater Indirect Ownership Interest | Dec 29, 2021 | 100% |
| Corporate Officer | Dec 29, 2021 | ||
| Corporate Director | Dec 29, 2021 | ||
| Brian J Fin | Corporate Director | Mar 15, 1992 | |
| Daniel Burns | W-2 Managing Employee | Dec 29, 2021 | |
| Nicholas Pugliese | W-2 Managing Employee | Dec 29, 2021 | |
| Woburn Operations LLC | 5% Or Greater Direct Ownership Interest | Dec 29, 2021 | 100% |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Winchester, MA
- NPI 1588668198
Boston Master Tenant LLC
-
- Skilled Nursing Facility
- Winchester, MA
- NPI 1619971215
Boston Master Tenant LLC
Practitioners & affiliated clinicians
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.
-
- Internal Medicine Physician
- Winchester, MA
- NPI 1568425346
-
- Internal Medicine Physician
- Wilmington, MA
- NPI 1912106691
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": "1118361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1285638890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 FRANCES ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018013006",
"telephone_number": "781-933-8175",
"fax_number": "781-729-3817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 FRANCES ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018013006",
"telephone_number": "781-933-8175",
"fax_number": "781-729-3817"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOBURN NURSING CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DRISCOLL",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "781-994-2114",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "4213",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS/SECURE HORIZON",
"identifier": "803059",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0906905",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH",
"identifier": "903183",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2222539401",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/ US HEALTHCARE",
"identifier": "552468",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woburn, MA
- Woburn Family Practice, Inc
- Woburn Hairmate Salon Inc. (Hairmate salon & Wigs)
- Woburn Medical Associates PC
- Woburn Nephrology Associates PC
- Woburn Nephrology Associates PC
- Woburn Pediatric Associates (North Andover Pediatric Associates)
- Woburn Pediatric Psychological Services PLLC
- Woburn Physical Therapy, Inc (Physical Therapy of Woburn)
- Woburn Public Schools
- Woburn Smiles PC (Prime Dental)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.