Home for the Aged of the Little Sisters of the Poor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7003303N Issued in NY

Legal business name

HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR

Doing business as

Queen of Peace Residence

Practice address

110-30 221St Street
Queens Village, NY 11429-2513

Phone

(718) 464-1800

NPI assigned

Oct 11, 2006

Last updated

Oct 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Celine Vadukkoot

Title

Ceo and Administrator

Phone

(718) 464-1800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Queen of Peace Residence Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306934732. Details of each certification follow.

• CCN 335606 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 335606

Legal name

HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR

Doing business as

QUEEN OF PEACE RESIDENCE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1977

Last certification

Jun 20, 2023

Beds

53

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Oct 4, 1869 in NY

Enrollment address

11030 221St St
Queens Village, NY 11429-2531

Nursing home name

QUEEN OF PEACE RESIDENCE

Affiliated entity

LITTLE SISTERS OF THE POOR

Listed as

Queen Of Peace ResidenceCCN 335606 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5329.2 residents per day on average

Chain

Little Sisters of the Poor4 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

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

• Erik K Johnson, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1679545727

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 3

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.

• Robert G Curran, M.D.

  • Internal Medicine Physician
  • Wantagh, NY
  • NPI 1700820818
  NPD (past)
• Erik K Johnson, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1679545727
  NPD (past)
• Syed Adil Kamal, M.D.

  • Internal Medicine Physician
  • Woodbury, NY
  • NPI 1013232396
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Erik K Johnson, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1679545727

  Nursing home

  Care Compare affiliation
• Syed Adil Kamal, M.D.

  • Internal Medicine Physician
  • Woodbury, NY
  • NPI 1013232396

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1306934732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110-30 221ST STREET",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292513",
            "telephone_number": "718-464-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-30 221ST STREET",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292513",
            "telephone_number": "718-464-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME FOR THE AGED OF THE LITTLE SISTERS OF THE POOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "VADUKKOOT",
        "authorized_official_first_name": "CELINE",
        "authorized_official_title_or_position": "CEO AND ADMINISTRATOR",
        "authorized_official_telephone_number": "718-464-1800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7003303N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00311495",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queen of Peace Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hollis Vision Center, Ocho, LLC
• Tatiana Holly
• Kelly A Holmes
• Home Care at Its Best
• Home Care at Its Best Inc
• Regina Hooper
• Jennifer Hossain, PHARMD
• Sam Hossaini, PHARMD
• Wahid Hossaini, R.PH
• Abigayle Kenease Howell

• Skilled Nursing Facility in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.

Verify at the official NPI Registry.