Active NPI
Eastern Orthodox Management Corporation
- Skilled Nursing Facility
- Worcester, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0970
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2222564801 | Other | MA | BLUE CROSS |
| 7100305 | Other | MA | EVERCARE |
| 0921858 | Medicaid | MA | |
| 802933 | Other | MA | TUFTS |
| 70012222564801 | Other | MA | MEDEX |
| 904691 | Other | MA | PILGRIM |
Other names 1
- Holy Trinity Nursing and Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Aug 22, 1994
- Medicare certification status
- Active
- Certified beds
- 113
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0892050 | Eastern Orthodox Management Corporation | Certificate of waiver | Sep 21, 2026 |
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Worcester, MA
- NPI 1417159153
Member Of
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Christopher Harry Stamas | Managing Control - Governing Body | Oct 1, 2020 | |
| Trustee of the SNF | Oct 1, 2020 | ||
| Ioannis Mironidis | Corporate Director | May 1, 2019 | |
| Katherine M Mshooshian | Managing Control - Governing Body | Sep 1, 2019 | |
| Trustee of the SNF | Sep 1, 2019 | ||
| William P Kiritsy | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| Lea Fontaine Christo | Managing Control - Governing Body | Oct 1, 2021 | |
| Trustee of the SNF | Oct 1, 2021 | ||
| Diane P Karalekas | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| Rodolfo Parra | Corporate Officer | Jul 6, 2021 | |
| Corporate Director | Jul 6, 2021 | ||
| Operational/Managerial Control | Jul 6, 2021 | ||
| Adp of the SNF | Feb 14, 2025 | ||
| Joanne McMahan | Managing Control - Governing Body | Oct 1, 2021 | |
| Trustee of the SNF | Oct 1, 2021 | ||
| Gabriela M Bitar | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| Nicholas M Paleologos | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| Samir M Bitar | 5% Or Greater Direct Ownership Interest | Oct 1, 2024 | |
| Corporate Officer | Oct 10, 2024 | ||
| Corporate Director | Oct 1, 2024 | ||
| Managing Control - Governing Body | Oct 1, 2024 | ||
| Trustee of the SNF | Oct 1, 2024 | ||
| Direct Ownership Interest | Oct 10, 2024 | ||
| Bogdan Nedelescu | Operational/Managerial Control | Dec 1, 2004 | |
| Adp of the SNF | Dec 1, 2004 | ||
| Michael John Dionis | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| Deborah Elizabeth Sedares | Managing Control - Governing Body | Jan 9, 2025 | |
| Trustee of the SNF | Jan 9, 2025 | ||
| William J Tsoules | Corporate Officer | Oct 1, 2023 | |
| Operational/Managerial Control | Oct 1, 2023 | ||
| Managing Control - Governing Body | Oct 1, 2023 | ||
| Trustee of the SNF | Oct 1, 2023 | ||
| Direct Ownership Interest | Oct 1, 2023 | ||
| Milad Selim | Managing Control - Governing Body | Oct 1, 2021 | |
| Trustee of the SNF | Oct 1, 2021 | ||
| Indirect Ownership Interest | Oct 1, 2021 | ||
| Marlene a Soter Tucker | Managing Control - Governing Body | Oct 1, 2019 | |
| Trustee of the SNF | Oct 1, 2019 | ||
| Eugenia P Liacopulos | Managing Control - Governing Body | 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.
-
- Ophthalmology Physician
- Marlborough, MA
- NPI 1992742944
Managing Control - Governing Body, Trustee of the SNF
-
- Nurse Practitioner
- Boston, MA
- NPI 1659409928
Indirect Ownership Interest, Managing Control - Governing Body, Trustee of the SNF
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1699732800
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1619914835
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1699732800
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2021; 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.