Jewish Home for the Elderly of Fairfield County Incorporated
Organization Active NPI Rehabilitation Clinic/Center · Bridgeport, CT
NPI 1285962928 · NPPES record last updated Aug 14, 2024
Key facts
- NPI
- 1285962928
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Clinic/Center 261QR0400X
- Legal business name
- JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED
- Practice address
- 4200 Park Ave
Bridgeport, CT 06604-1049 - Phone
- (203) 365-6400
- NPI assigned
- Nov 18, 2009
- Organization subpart
- No
Authorized official
- Name
- Sheila Robinson
- Title
- Ar Supervisor
- Phone
- (203) 396-1075
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 5
Practitioners 21
-
Shawna Marie O'Neil, MS, CCC-SLP
-
Kendall Morgan Stewart, PT, DPT
-
Rachel Triplett, PT
-
Claudia Abreu, OTR/L
-
John Feiler, OCCUPATIONAL THERAPI
-
Kristin Copeland, PT
-
Taylor Drayton, DPT
-
Hailey Diane Power, PT, DPT
-
Madison P Altermatt, OTR/L
-
Allison Brown, OTR/L
-
Jaclyn Dias, PT, DPT, GCS
-
Sarah Ann Kagan, OTR/L
-
Jennifer Peterson, OTR/L
-
Caitlin R Sposato, PT, DPT
-
Jaclyn W Bellaby, CCC-SLP
-
Julia D. Portale, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Mozaic Senior Life |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1973 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140610000429 | CT | Part B Supplier - Clinic/Group Practice | 6901706332 |
Receives reassigned benefits from 19 practitioners Practice locations: Bridgeport, CT |
National Provider Directory
- Tax ID family
- The Jewish Home for the Elderly of Fairfield County Inc
Locations
1 Post Rd
Fl 3
Fairfield, CT 06824
Phone (203) 365-8454
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Yes |
Addresses
Primary practice location
4200 Park Ave
Bridgeport, CT 06604-1049
Mailing address
4200 Park Ave
Bridgeport, CT 06604-1049
Phone (203) 365-6400
Other names
- Mozaic Outpatient Rehab
- Mozaic Senior Life
Other providers in Bridgeport, CT
- Bernadine Jerry
- Albert Jeudi
- Jewel of Joy Counseling Services
- Jewish Family Service, Inc.
- Jewish Home for the Elderly of Fairfield County Incorporated
- Jewish Home for the Elderly of Fairfield County Incorporated
- Jewish Home for the Elderly of Fairfield County Incorporated
- Jewish Home for the Elderly of Fairfield County Incorporated
- Yanxi Jiang-Nast
- Emily Nicole Jimenez
All providers in Bridgeport, CT · Rehabilitation Clinic/Center in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.