Marblehead Healthcare Solutions LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MARBLEHEAD HEALTHCARE SOLUTIONS LLC

Doing business as

Devereux Skilled Nursing & Rehabilitation Center

Practice address

39 Lafayette St
Marblehead, MA 01945-1939

Phone

(781) 631-6120

NPI assigned

Jul 20, 2022

Last updated

Jul 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tariq Qureshi

Title

Partner

Phone

(617) 504-0294

Specialties & licenses 2

Addresses

Other names 1

• Devereux Skilled Nursing & Rehabilitation Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568197804. Details of each certification follow.

• CCN 225398 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 225398

Legal name

MARBLEHEAD HEALTHCARE SOLUTIONS LLC

Doing business as

DEVEREUX SKILLED NURSING & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1990

Last certification

Aug 21, 2024

Beds

64

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

39 Lafayette St
Marblehead, MA 01945-1939

Nursing home name

DEVEREUX SKILLED NURSING & REHABILITATION CENTER

Listed as

Devereux Skilled Nursing & Rehabilitation CenterCCN 225398 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 1, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6451.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Saeid Elmi, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Medford, MA
  • NPI 1023105459

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Saeid Elmi, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Medford, MA
  • NPI 1023105459
  NPD (past)

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1568197804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 NAHANT RD",
            "city": "NAHANT",
            "state": "MA",
            "postal_code": "019081341",
            "telephone_number": "781-581-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 LAFAYETTE ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019451939",
            "telephone_number": "781-631-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARBLEHEAD HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-504-0294"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Devereux Skilled Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mark a Lewis, MD

• Skilled Nursing Facility in Marblehead, MA
• Providers in Marblehead, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.

Verify at the official NPI Registry.