Organization Active NPI

Eastern Orthodox Management Corporation

  • Skilled Nursing Facility
  • Worcester, MA
National Provider Identifier
1497740773
Registry record updated Jul 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0970 Issued in MA
Legal business name
EASTERN ORTHODOX MANAGEMENT CORPORATION
Practice address
300 Barber Ave
Worcester, MA 01606-2476
Phone
(508) 852-1000
Fax
(508) 854-1622
NPI assigned
Sep 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2021

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

Authorized official

Name
Ioannis Mironidis
Title
It Director
Phone
(508) 852-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0970 MA Primary

Addresses

Primary practice location

300 Barber Ave
Worcester, MA 01606-2476

Mailing address

300 Barber Ave
Worcester, MA 01606-2476
Phone (508) 852-1000

Other identifiers 6

IdentifierTypeStateIssuer
2222564801OtherMABLUE CROSS
7100305OtherMAEVERCARE
0921858MedicaidMA
802933OtherMATUFTS
70012222564801OtherMAMEDEX
904691OtherMAPILGRIM

Other names 1

  • Holy Trinity Nursing and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070709000325 MA Part A Provider - Skilled Nursing Facility 6901906767 Practice locations: Worcester, MA

Skilled nursing facility certification: CCN 225648

Legal name
EASTERN ORTHODOX MANAGEMENT CORPORATION
Doing business as
HOLY TRINITY NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 22, 1994
Last certification
Sep 23, 2024
Beds
113
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 24, 1994 in MA
Enrollment address
300 Barber Ave
Worcester, MA 01606-2476
Nursing home name
HOLY TRINITY EASTERN ORTHODOX N & R CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Holy Trinity Eastern Orthodox N & R CenterCCN 225648
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 22, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
113104.9 residents per day on average

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
22D0892050Eastern Orthodox Management Corporation300 Barber Avenue, Worcester, MA 01606Certificate of waiverSep 21, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

300 Barber Ave
Worcester, MA 01606
Phone (508) 852-1000

2 Foster St
Worcester, MA 01608
Phone (508) 791-8200

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Christopher Harry Stamas Individual Managing Control - Governing BodyBoard of Director Oct 1, 2020
Trustee of the SNF Oct 1, 2020
Ioannis Mironidis Individual Corporate DirectorIt Director May 1, 2019
Katherine M Mshooshian Individual Managing Control - Governing BodySecretary of the Board Sep 1, 2019
Trustee of the SNF Sep 1, 2019
William P Kiritsy Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
Lea Fontaine Christo Individual Managing Control - Governing BodyBoard of Director Oct 1, 2021
Trustee of the SNF Oct 1, 2021
Diane P Karalekas Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
Rodolfo Parra Individual Corporate OfficerCeo Jul 6, 2021
Corporate DirectorAdministrator Jul 6, 2021
Operational/Managerial Control Jul 6, 2021
Adp of the SNF Feb 14, 2025
Joanne McMahan Individual Managing Control - Governing BodyVice President of the Board of Dire Oct 1, 2021
Trustee of the SNF Oct 1, 2021
Gabriela M Bitar Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
Nicholas M Paleologos Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
Samir M Bitar Individual 5% Or Greater Direct Ownership InterestPresident of the Board Oct 1, 2024
Corporate OfficerPresident of the Board Oct 10, 2024
Corporate DirectorPresident of the Board Oct 1, 2024
Managing Control - Governing BodyPresident of the Board Oct 1, 2024
Trustee of the SNF Oct 1, 2024
Direct Ownership Interest Oct 10, 2024
Bogdan Nedelescu Individual Operational/Managerial Control Dec 1, 2004
Adp of the SNF Dec 1, 2004
Michael John Dionis Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
Deborah Elizabeth Sedares Individual Managing Control - Governing BodyBoard of Director Jan 9, 2025
Trustee of the SNF Jan 9, 2025
William J Tsoules Individual Corporate OfficerTreasurer Oct 1, 2023
Operational/Managerial Control Oct 1, 2023
Managing Control - Governing BodyTreasurer Oct 1, 2023
Trustee of the SNF Oct 1, 2023
Direct Ownership Interest Oct 1, 2023
Milad Selim Individual Managing Control - Governing BodyBoard of Director Oct 1, 2021
Trustee of the SNF Oct 1, 2021
Indirect Ownership Interest Oct 1, 2021
Marlene a Soter Tucker Individual Managing Control - Governing BodyBoard of Director Oct 1, 2019
Trustee of the SNF Oct 1, 2019
Eugenia P Liacopulos Individual Managing Control - Governing BodyBoard of Director Oct 1, 2021
Trustee of the SNF Oct 1, 2021
Indirect Ownership Interest Oct 1, 2021

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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625270400000",
    "number": "1497740773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BARBER AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062476",
            "telephone_number": "508-852-1000",
            "fax_number": "508-854-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BARBER AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062476",
            "telephone_number": "508-852-1000",
            "fax_number": "508-854-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN ORTHODOX MANAGEMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A",
        "authorized_official_last_name": "MIRONIDIS",
        "authorized_official_first_name": "IOANNIS",
        "authorized_official_title_or_position": "IT DIRECTOR",
        "authorized_official_telephone_number": "508-852-1000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2222564801",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "7100305",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0921858",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "802933",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDEX",
            "identifier": "70012222564801",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PILGRIM",
            "identifier": "904691",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Trinity Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holy Trinity Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.