CCC of Pewaukee LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CCC OF PEWAUKEE LLC

Practice address

N26W23977 Watertown Rd
Waukesha, WI 53188-1006

Phone

(847) 983-4860

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

David Merzel

Title

Cfo

Phone

(847) 983-4860

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Avina of Pewaukee Doing business as
• Crossroads Care Center of Pewaukee Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Skilled nursing facility certification: CCN 525646

Legal name

CCC OF PEWAUKEE LLC

Doing business as

AVINA OF PEWAUKEE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 28, 1998

Last certification

Mar 4, 2024

Beds

120

Ownership / control type

Corporation

Multi-facility organization

AA Healthcare

Most recent change of ownership

Nov 1, 2018

Organization structure

LLCProprietary

Enrollment address

N26W23977 Watertown Rd
Waukesha, WI 53188-1006

Nursing home name

AVINA OF PEWAUKEE

Affiliated entity

AVINA HEALTHCARE

Listed as

Avina of PewaukeeCCN 525646

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 28, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12088.7 residents per day on average

Chain

Avina Healthcare9 facilities in the chain

Penalties (3 years)

1Fines totaling $95,791

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 6

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jaswinder Sidhu, M.D.

  • Internal Medicine Physician
  • Oconomowoc, WI
  • NPI 1073628509

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1578049995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 FARGO AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773210",
            "telephone_number": "847-983-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N26W23977 WATERTOWN RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881006",
            "telephone_number": "847-983-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC OF PEWAUKEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "MERZEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-983-4860"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578049995",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Avina of Pewaukee",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Care Center of Pewaukee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tressa M Catalani
• Cindy B Catania, DO
• Catholic Charities of the Archdiocese of Milwaukee Inc
• Sarah Ann Cavitt, RDH
• Julie Cayer, RDH
• Nancy L. Cechvala, M.S.
• Annette Centeno
• Kimberly Sue Centgraf, DVM
• Jennifer Lynn Cera, BSW
• Anna E Cerny, RDH

• Skilled Nursing Facility in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.