NPIMap

Organization Active NPI

57 Old Road to Nine Acre Corner Operating Company, LLC

Doing business as Concord Healthcare Center

  • Skilled Nursing Facility
  • Concord, MA
National Provider Identifier
1295734911
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0983 Issued in MA
Legal business name
57 OLD ROAD TO NINE ACRE CORNER OPERATING COMPANY, LLC
Doing business as
Concord Healthcare Center
Practice address
57 Old Road to 9 Acre Corner
Concord, MA 01742
Phone
(978) 371-3400
Fax
(978) 371-3406
NPI assigned
Jul 14, 2005
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Emily Vazquez
Title
VP, Special Projects
Phone
(978) 930-6051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0983 MA Primary

Addresses

Primary practice location

57 Old Road to 9 Acre Corner
Concord, MA 01742

Mailing address

57 Old Road to 9 Acre Corner
Concord, MA 01742
Phone (978) 371-3400

Other identifiers 1

IdentifierTypeStateIssuer
0926787MedicaidMD

Other names 1

  • Concord Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030522000046 MA Part A Provider - Skilled Nursing Facility 3678483039 Practice locations: West Concord, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295734911. Details of each certification follow.

Skilled nursing facility certification: CCN 225663

Legal name
57 OLD ROAD TO NINE ACRE CORNER OPERATING COMPANY, LLC
Doing business as
CARE ONE AT CONCORD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 10, 1995
Last certification
Jan 23, 2025
Beds
135
Ownership / control type
Corporation
Multi-facility organization
Healthbridge
Organization structure
LLCProprietary
Incorporated
Apr 29, 2002 in DE
Enrollment address
57 Old Road to Nine Acre Corner
Care One at Concord
West Concord, MA 01742-3317
Nursing home name
CARE ONE AT CONCORD
Affiliated entity
CAREONE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Care One at ConcordCCN 225663 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 10, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
135129.3 residents per day on average
Chain
Careone37 facilities in the chain
Penalties (3 years)
1Fines totaling $7,901

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
22D0896299Concord Health Care Center Dba Care-One at57 Old Road to Nine Acre Corner, Concord, MA 01742Certificate of waiverJan 4, 2027

National Provider Directory

National Provider Directory

Locations

57 Old Road To 9 Acre Cor
#One
Concord, MA 01742
Phone (978) 371-3400

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Healthbridge Management LLC Organization, Fort Lee, NJ For-profit Operational/Managerial Control Jul 1, 2003
David Baruch Individual Corporate Officer Dec 1, 2021
W-2 Managing Employee Dec 1, 2021
Care Realty, LLC Organization, Fort Lee, NJ For-profit 5% Or Greater Indirect Ownership Interest Apr 30, 2002
Thci of Massachusetts, LLC Organization, Fort Lee, NJ For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2003
Daniel E Straus Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2003
Des-I 2016 Grat Organization, Fort Lee, NJ 5% Or Greater Indirect Ownership Interest Dec 1, 2021

Facilities with the same owner 39

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

View all 39

Practitioners & affiliated clinicians

Practitioners 4

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.

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": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1295734911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 OLD ROAD TO 9 ACRE CORNER",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-371-3400",
            "fax_number": "978-371-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 OLD ROAD TO 9 ACRE CORNER",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-371-3400",
            "fax_number": "978-371-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "57 OLD ROAD TO NINE ACRE CORNER OPERATING COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "VP, SPECIAL PROJECTS",
        "authorized_official_telephone_number": "978-930-6051"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0926787",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concord Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.