NPIMap

Organization Active NPI

Chelsea Jewish Community, Inc.

Doing business as Chelsea Jewish Visiting Nurse Agency

  • Home Health Agency
  • Chelsea, MA
National Provider Identifier
1528519980
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CHELSEA JEWISH COMMUNITY, INC.
Doing business as
Chelsea Jewish Visiting Nurse Agency
Practice address
123 Captains Row
Chelsea, MA 02150
Phone
(617) 889-0779
NPI assigned
Oct 20, 2016
Organization subpart
Yes
Parent organization
CHELSEA JEWISH LIFECARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Adam Berman
Title
President
Phone
(978) 471-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

123 Captains Row
Chelsea, MA 02150

Mailing address

165 Captains Row
Chelsea, MA 02150
Phone (978) 887-0001

Other identifiers 1

IdentifierTypeStateIssuer
110024502AMedicaidMA

Other names 1

  • Chelsea Jewish Visiting Nurse Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161212001640 MA Part A Provider - Home Health Agency 2961632708 Practice locations: Chelsea, MA

Home health agency certification: CCN 227450

Legal name
CHELSEA JEWISH COMMUNITY, INC.
Doing business as
LEGACY LIFECARE VISITING NURSE AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 10, 1996
Last certification
Sep 28, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Oct 24, 2007 in MA
Enrollment address
123 Captains Row
Chelsea, MA 02150-4019

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: Home health agency

Medicare Care Compare
Listed as
Legacy Lifecare Visiting Nurse AgencyCCN 227450 · All quality measures
Overall star rating
4 of 5
Ownership
Non-Profit
Certified
Dec 10, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Chelsea Jewish Community Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

123 Captains Row
Chelsea, MA 02150
Phone (617) 889-0779

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jeffrey Brudnick Individual Corporate Director Jan 1, 2002
Sharon Forman Individual Corporate DirectorDirector Jan 1, 2017
Stuart a Anfang Individual Corporate DirectorDirector Oct 1, 2020 8%
Charlotte Florence Individual Corporate DirectorDirector Jan 1, 2017
Susan Goldsmith Individual Corporate Director May 1, 2013 4%
Jennifer Santerre Individual Corporate OfficerCfo Jul 1, 2022
Elizabeth Mullen Individual Corporate OfficerClerk Jan 1, 2017 16%
Corporate DirectorClerk Jan 1, 2017 16%
Legacy Lifecare Inc Organization, Peabody, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2021 100%
Karen N Madrid Individual W-2 Managing EmployeeClinical Director Jan 1, 2021
Adam S Berman Individual Corporate OfficerPresident Jan 1, 2017 16%
Corporate DirectorPresident Jan 1, 2017 16%
Judy Weiss Individual Corporate Director Oct 1, 2018 8%
Douglas Fiebelkorn Individual Corporate Director Nov 1, 2022 8%
Gilda Richman Individual Corporate Director Jan 1, 2002
Chelsea Jewish Lifecare Inc Organization, Chelsea, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2017 100%
Barry S Berman Individual Corporate OfficerTreasurer Jan 1, 2017
Corporate DirectorTreasurer Jan 1, 2017
Howard Greenspan Individual Corporate Director Jan 1, 2018

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2017 Change of OwnershipThis provider was the buyer Chelsea Jewish Visiting Nurse AgencyCCN 227450, MA, NPI 1861482499

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

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": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1528519980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CAPTAINS ROW",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "978-887-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CAPTAINS ROW",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "02150",
            "telephone_number": "617-889-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHELSEA JEWISH COMMUNITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHELSEA JEWISH LIFECARE, INC.",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-471-5100"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110024502A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chelsea Jewish Visiting Nurse Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.