NPIMap

Organization Active NPI

Chatsworth at Wellington Green LLC

Doing business as NuVista Living at Wellington Green

  • Skilled Nursing Facility
  • Wellington, FL
National Provider Identifier
1487955654
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHATSWORTH AT WELLINGTON GREEN LLC
Doing business as
NuVista Living at Wellington Green
Practice address
10330 Devonshire Blvd
Wellington, FL 33414-9302
Phone
(561) 795-3360
NPI assigned
Nov 4, 2010
Last updated
Dec 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Mr. Paul M Walczak II
Title
Manager
Phone
(561) 366-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X FL Primary

Addresses

Primary practice location

10330 Devonshire Blvd
Wellington, FL 33414-9302

Mailing address

PO Box 31809
Palm Beach Gardens, FL 33420-1809
Phone (561) 366-6600

Other names 1

  • NuVista Living at Wellington Green Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000760 FL Part B Supplier - Clinic/Group Practice 3678733342 Receives reassigned benefits from 254 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Palm Beach, FL; Wellington, FL; Riviera Beach, FL; Palm Beach Gardens, FL; Lake Worth, FL; Jupiter, FL; Delray Beach, FL; Atlantis, FL…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1487955654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31809",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334201809",
            "telephone_number": "561-366-6600",
            "fax_number": "561-273-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 DEVONSHIRE BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334149302",
            "telephone_number": "561-795-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATSWORTH AT WELLINGTON GREEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "WALCZAK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-366-6600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NuVista Living at Wellington Green",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.