NPIMap

Organization Active NPI

30 Princeton Opco LLC

  • Skilled Nursing Facility
  • Lowell, MA
National Provider Identifier
1619699394
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 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
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Eliyahu Mirlis
Title
Authorized Representative
Phone
(973) 796-6175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

30 Princeton Blvd
Lowell, MA 01851-2405

Mailing address

30 Princeton Blvd
Lowell, MA 01851-2405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221209002299 MA Part A Provider - Skilled Nursing Facility 2769851955 Practice locations: Lowell, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619699394. Details of each certification follow.

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
LLCProprietary
Enrollment address
30 Princeton Blvd
Lowell, MA 01851-2405
Nursing home name
REGALCARE AT LOWELL
Affiliated entity
REGALCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Regalcare at LowellCCN 225511 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
9062.4 residents per day on average
Chain
Regalcare9 facilities in the chain
Penalties (3 years)
2Fines totaling $91,558

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0071958Regalcare at Lowell30 Princeton Blvd, Lowell, MA 01851Certificate of waiverApr 2, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Eliyahu Mirlis Individual 5% Or Greater Direct Ownership Interest Nov 1, 2022 100%
W-2 Managing Employee Nov 1, 2022

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 4

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": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1619699394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PRINCETON BLVD",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PRINCETON BLVD",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512405",
            "telephone_number": "978-454-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "30 PRINCETON OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "MIRLIS",
        "authorized_official_first_name": "ELIYAHU",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "973-796-6175"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.