NPIMap

Organization Active NPI

Northbridge Health Care Center, Inc.

Doing business as Northbridge Health Care Center

  • Skilled Nursing Facility
  • Bridgeport, CT
National Provider Identifier
1558314955
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2183C Issued in CT
Legal business name
NORTHBRIDGE HEALTH CARE CENTER, INC.
Doing business as
Northbridge Health Care Center
Practice address
2875 Main Street
Bridgeport, CT 06606
Phone
(203) 336-0232
Fax
(203) 336-0234
NPI assigned
May 18, 2006
Last updated
Feb 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Authorized official

Name
Lawrence G. Santilli
Title
President/Ceo
Phone
(860) 751-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2183C CT Primary

Addresses

Primary practice location

2875 Main Street
Bridgeport, CT 06606

Mailing address

2875 Main Street
Bridgeport, CT 06606
Phone (203) 336-0232

Other identifiers 2

IdentifierTypeStateIssuer
000010835MedicaidCT
IR8003OtherCTHEALTHNET

Other names 1

  • Northbridge Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070920000030 CT Part A Provider - Skilled Nursing Facility 4587758651 Practice locations: Bridgeport, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558314955. Details of each certification follow.

Skilled nursing facility certification: CCN 075413

Legal name
NORTHBRIDGE HEALTH CARE CENTER, INC.
Doing business as
NORTHBRIDGE HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 15, 1996
Last certification
Jun 26, 2024
Beds
145
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Civita Care
Organization structure
CorporationProprietary
Incorporated
Jan 18, 1996 in CT
Enrollment address
2875 Main St
Bridgeport, CT 06606-4204
Nursing home name
CIVITA CARE NORTHBRIDGE
Affiliated entity
ATHENA HEALTHCARE SYSTEMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Civita Care NorthbridgeCCN 075413 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 15, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
145121.0 residents per day on average
Chain
Athena Healthcare Systems22 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
4Fines totaling $148,053

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Northbridge Health Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lawrence E Santilli Individual 5% Or Greater Direct Ownership Interest Sep 30, 2017 13.27%
Michael E Mosier Individual Corporate OfficerDelegated Official/Officer Jul 1, 2007 4%
Athena Health Care Associates, Inc. Organization, Farmington, CT Corporation, Management services company, For-profit Operational/Managerial Control Oct 18, 1996
Erica Roman Individual W-2 Managing EmployeeAdministrator Jan 1, 2016
Lawrence G Santilli Individual 5% Or Greater Direct Ownership Interest Sep 30, 2017 76.23%
Corporate OfficerOfficer Oct 18, 1996
Corporate DirectorAuthorized Official/Director Oct 18, 1996

Facilities with the same owner 25

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

View all 25

Practitioners & affiliated clinicians

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1558314955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 MAIN STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-336-0232",
            "fax_number": "203-336-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MAIN STREET",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-336-0232",
            "fax_number": "203-336-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHBRIDGE HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "SANTILLI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "860-751-3900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2183C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010835",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IR8003",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northbridge Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.