Active NPI
Ledgewood SNF LLC
Doing business as Ledgewood Rehabilitation and Skilled Nursing Center
- Skilled Nursing Facility
- Beverly, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- LEDGEWOOD SNF LLC
- Doing business as
- Ledgewood Rehabilitation and Skilled Nursing Center
- Practice address
- 87 Herrick St
Beverly, MA 01915-2773 - Phone
- (978) 921-1392
- Fax
- (978) 921-7140
- NPI assigned
- Feb 24, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert Joseph Difrancesco
- Title
- Director
- Phone
- (781) 501-9761
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
87 Herrick St
Beverly, MA 01915-2773
Mailing address
350 Granite St Ste 2203
Braintree, MA 02184-4963
Phone (781) 501-9761
Other names 1
- Ledgewood Rehabilitation and Skilled Nursing Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210514001408 | MA | Part A Provider - Skilled Nursing Facility | 6305255753 | Practice locations: Beverly, MA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1629662275. Details of each certification follow.
Skilled nursing facility certification: CCN 225309
- Legal name
- LEDGEWOOD SNF LLC
- Doing business as
- LEDGEWOOD REHABILITATION AND SKILLED NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 28, 1988
- Last certification
- Aug 1, 2024
- Beds
- 123
- Ownership / control type
- Corporation
- Multi-facility organization
- Bane Care
- Organization structure
- LLC
- Incorporated
- Dec 16, 2020 in MA
- Enrollment address
- 87 Herrick Street
Beverly, MA 01915-2773 - Nursing home name
- LEDGEWOOD REHABILITATION AND NURSING CENTER
- Affiliated entity
- BANECARE MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Ledgewood Rehabilitation and Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 28, 1988
- Medicare certification status
- Active
- Certified beds
- 123
- Chain
- Banecare Management
National Provider Directory
National Provider DirectoryLocations
87 Herrick St
Beverly, MA 01915
Phone (978) 685-8086
350 Granite St
Ste 2203
Braintree, MA 02184
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Paul Mahoney | W-2 Managing Employee | Jun 1, 2021 | |
| Kevin P Morris | 5% Or Greater Direct Ownership Interest | Dec 16, 2020 | 100% |
| Operational/Managerial Control | Dec 16, 2020 | 100% |
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Internal Medicine Physician
- Cambridge, MA
- NPI 1205999752
-
- Internal Medicine Physician
- Gloucester, MA
- NPI 1538111422
Affiliated clinicians 2
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": "1614124800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614124800000",
"number": "1629662275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 GRANITE ST STE 2203",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021844963",
"telephone_number": "781-501-9761",
"fax_number": "781-871-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 HERRICK ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019152773",
"telephone_number": "978-921-1392",
"fax_number": "978-921-7140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEDGEWOOD SNF LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-24",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A",
"authorized_official_last_name": "DIFRANCESCO",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "781-501-9761",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Ledgewood Rehabilitation and Skilled Nursing Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.