NPIMap

Organization Active NPI

Newark Wayne Community Hospital

Doing business as Wayne Health Care- DeMay Living Center

  • Skilled Nursing Facility
  • Newark, NY
National Provider Identifier
1295803070
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5820000N Issued in NY
Legal business name
NEWARK WAYNE COMMUNITY HOSPITAL
Doing business as
Wayne Health Care- DeMay Living Center
Wayne Health Care-Vent
Practice address
100 Sunset Dr
Newark, NY 14513-1068
Phone
(315) 332-2022
NPI assigned
Dec 1, 2006
Last updated
Sep 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Authorized official

Name
Thomas Crilly
Title
Cfo
Phone
(585) 922-5497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5820000N NY Primary

Addresses

Primary practice location

100 Sunset Dr
Newark, NY 14513-1068

Mailing address

100 Sunset Dr
Newark, NY 14513-1068
Phone (315) 332-2022

Other identifiers 3

IdentifierTypeStateIssuer
20OtherNYBLUESHIELD
00355702MedicaidNY
P015002600OtherNYBLUE CHOICE

Other names 2

  • Wayne Health Care- DeMay Living Center Doing business as
  • Wayne Health Care-Vent Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061122000080 NY Part A Provider - Skilled Nursing Facility 0446154199 1 other NPI on this enrollment
Practice locations: Newark, NY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295803070. Details of each certification follow.

Skilled nursing facility certification: CCN 335403

Legal name
NEWARK WAYNE COMMUNITY HOSPITAL
Doing business as
WAYNE HEALTH CARE-DEMAY LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 6, 1973
Last certification
Sep 13, 2024
Beds
182
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 20, 1953 in NY
Enrollment address
100 Sunset Dr
Newark, NY 14513-1068
Nursing home name
WAYNE HEALTH CARE
Affiliated entity
ROCHESTER REGIONAL HEALTH

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wayne Health CareCCN 335403 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 6, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
182174.2 residents per day on average
Chain
Rochester Regional Health5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Dawn K Riedy7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Julia C Tedesco Individual Corporate DirectorBoard Secretary Jul 1, 2020
Dawn Kathleen Riedy Individual Corporate DirectorBoard Member Jul 1, 2020
Marcy Cardona Mulconry Individual Corporate DirectorBoard Member Jul 1, 2020
Karen M Gallina Individual Corporate DirectorBoard Chair Jul 1, 2020
Ralph a. Destephano Individual Corporate DirectorBoard Member Jul 1, 2020
Karan Alag Individual Corporate DirectorBoard Member Jul 1, 2020
Elizabeth V. Patton Individual Corporate DirectorBoard Member Jul 1, 2020
Daniel M Meyers Individual Corporate DirectorBoard Member Jul 1, 2020
Shawn Hoyt Individual W-2 Managing Employee Apr 14, 2021
Nichole S Holder Individual W-2 Managing EmployeePayor Enrollment Director Jan 1, 2021
Patricia J Patton Individual W-2 Managing Employee Apr 1, 2015
Howard Glastonbury Individual Corporate OfficerVice President Cfo Corp. Finance Jan 1, 2021
W-2 Managing EmployeeVP Cfo Corporate Finance Jan 1, 2021
Dianne Cooney-Miner Individual Corporate DirectorBoard Vice-Chair Jul 1, 2020
Leon T Sawyko Individual Corporate DirectorBoard Member Jul 1, 2020
Paul Bernstein Individual Corporate OfficerRGH Med Staff President Jul 1, 2020
Thomas P Riley Individual Corporate DirectorBoard Member Jul 1, 2020
Linda S Becker Individual Corporate DirectorBoard Member Jul 1, 2020
Jeffrey C. Mapstone Individual Corporate DirectorBoard Treasurer Jul 1, 2020
Thomas R Crilly Individual Corporate OfficerExecutive Vice President, Cfo Apr 1, 2015
W-2 Managing EmployeeExecutive Vice President, Cfo Apr 1, 2015
Eric Joseph Bieber Individual Corporate OfficerPresident & Ceo Nov 4, 2014

Owners & managing parties with NPI records 3

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

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 4

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1295803070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SUNSET DR",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131068",
            "telephone_number": "315-332-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SUNSET DR",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131068",
            "telephone_number": "315-332-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK WAYNE COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "CRILLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-922-5497"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "5820000N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "20",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355702",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P015002600",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne Health Care- DeMay Living Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wayne Health Care-Vent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NY

Sources for this page

Verify at the official NPI Registry.