St. Mary's Home for the Aged, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

540 Issued in WI

Legal business name

ST. MARY'S HOME FOR THE AGED, INC

Practice address

1635 S 21St St
Manitowoc, WI 54220-6380

Phone

(920) 684-7171

Fax

(920) 684-0118

NPI assigned

Aug 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Frank Soltys, NHA, MSN

Title

Presidnet/Ceo/Nha/MSN

Phone

(920) 684-7171

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609882448. Details of each certification follow.

• CCN 525609 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525609

Legal name

ST. MARY'S HOME FOR THE AGED, INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1996

Last certification

Aug 14, 2024

Beds

84

Ownership / control type

Church Related

Multi-facility organization

Felician Services, Inc.

Organization structure

CorporationNon-profit

Incorporated

Mar 30, 1956 in WI

Enrollment address

1635 S 21St St
Manitowoc, WI 54220-6380

Nursing home name

ST MARYS HOME FOR THE AGED

Affiliated entity

FELICIAN SERVICES

Listed as

St Marys Home for the AgedCCN 525609 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Church related

Certified

Dec 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8444.3 residents per day on average

Chain

Felician Services3 facilities in the chain

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

All disclosed owners & managing parties 21

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 2

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

• Cameron A Goetz, PHD

  • Clinical Psychologist
  • Manitowoc, WI
  • NPI 1932120607

  Corporate Director

  CMS ownership
• Sarfraz Singh Sidhu, M.D.

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1801946462

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 3

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

• Angela Hospice Home Care, Inc.

  • Community Based Hospice Care Agency
  • Livonia, MI
  • NPI 1003818220

  Felician Services Inc

  CMS ownership
• Marian Village Corporation

  dba Marywood Nursing Care Center/Marybrook Manor

  • Skilled Nursing Facility
  • Livonia, MI
  • NPI 1285721449

  Felician Services Inc

  CMS ownership
• St. Anne Home

  • Skilled Nursing Facility
  • Greensburg, PA
  • NPI 1578566725

  Felician Services Inc

  CMS ownership

Affiliated clinicians 5

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

• Samuel Quinn Ballard, DO

  • Internal Medicine Physician
  • Two Rivers, WI
  • NPI 1578191763

  Nursing home

  Care Compare affiliation
• Kelly Dawson, APNP

  • Nurse Practitioner
  • Sheboygan, WI
  • NPI 1346663838

  Nursing home

  Care Compare affiliation
• Lindsey Mae Novack

  • Family Nurse Practitioner
  • Manitowoc, WI
  • NPI 1629575261

  Nursing home

  Care Compare affiliation
• Sarfraz Singh Sidhu, M.D.

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1801946462

  Nursing home

  Care Compare affiliation
• Jin Yuan Wang, MD

  • General Practice Physician
  • Manitowoc, WI
  • NPI 1396372850

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1609882448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 S 21ST STREET",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205652",
            "telephone_number": "920-684-7171",
            "fax_number": "920-684-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 S 21ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542206380",
            "telephone_number": "920-684-7171",
            "fax_number": "920-684-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOME FOR THE AGED, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "SOLTYS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDNET/CEO/NHA/MSN",
        "authorized_official_telephone_number": "920-684-7171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA, MSN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20136700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joann P Sorenson, COTA
• Mary E Spaulding, APSW
• Sheridan M Specht, NP
• Basil P Spyropoulos, M.D.
• Punya Srikanth, DMD
• Debra Ann St.Pierre, RPH
• Brenda Stallbaum, APNP
• Diane L Staudinger, MD
• Megan Danielle Stein, COTA
• John M Stern, M.D.

• Skilled Nursing Facility in Manitowoc, WI
• Providers in Manitowoc, 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 Dec 15, 2015; 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.