30 Princeton Opco LLC
Organization Active NPI Skilled Nursing Facility · Lowell, MA
NPI 1619699394 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1619699394
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 30 PRINCETON OPCO LLC
- Practice address
- 30 Princeton Blvd
Lowell, MA 01851-2405 - Phone
- (978) 454-8086
- NPI assigned
- Sep 19, 2022
- Organization subpart
- No
Authorized official
- Name
- Eliyahu Mirlis
- Title
- Authorized Representative
- Phone
- (973) 796-6175
Practitioners 4
-
Zaheer Ahmed, M.D.
-
Michael G Bertos, M.D.
-
Louis J Bresnick, M.D.
-
Tushar M Patel, M.D.
Affiliated clinicians 4
-
Zaheer Ahmed, M.D.
-
Michael G Bertos, M.D.
-
Louis J Bresnick, M.D.
-
Tushar M Patel, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Regalcare at Lowell
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1990
- Medicare certification status
- Active
- Certified beds
- 90 · 62.4 residents per day on average
- Chain
- Regalcare
- Penalties (3 years)
- 2 · fines totaling $91,558
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0071958 | Regalcare at Lowell | Certificate of waiver | Apr 2, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Skilled nursing facility certification: CCN 225511
- Legal name
- 30 PRINCETON OPCO LLC
- Doing business as
- REGALCARE AT LOWELL
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1990
- Last certification
- Mar 31, 2025
- Beds
- 90
- Ownership / control type
- Corporation
- Multi-facility organization
- RegalCare
- Organization structure
- LLC · Proprietary
- Enrollment address
- 30 Princeton Blvd
Lowell, MA 01851-2405 - Nursing home name
- REGALCARE AT LOWELL
- Affiliated entity
- REGALCARE
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Eliyahu Mirlis |
5% Or Greater Direct Ownership Interest | Nov 1, 2022 | 100% |
| W-2 Managing Employee | Nov 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221209002299 | MA | Part a Provider - Skilled Nursing Facility | 2769851955 | Practice locations: Lowell, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
30 Princeton Blvd
Lowell, MA 01851-2405
Mailing address
30 Princeton Blvd
Lowell, MA 01851-2405
Other providers in Lowell, MA
- 19 Varnum Street Operating Co,LLC
- 19 Varnum Street Operating Company, LLC
- 30 Princeton Boulevard Operations LLC
- 841 Merrimack Street Operations LLC
- A & S Dental Wellness Center of Lowell, P. C.
- A1 Care Inc
- Rachelle Marcella Aaron
- Majed Mohammad Abbas
All providers in Lowell, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.