Organization Active NPI

Edgewood Retirement Community, Inc

  • Skilled Nursing Facility
  • North Andover, MA
National Provider Identifier
1659354355
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
OTTG Issued in MA
Legal business name
EDGEWOOD RETIREMENT COMMUNITY, INC
Practice address
575 Osgood St
North Andover, MA 01845-1975
Phone
(978) 725-3300
Fax
(978) 725-5997
NPI assigned
Nov 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marlene Rotering
Title
Executive Director
Phone
(978) 725-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X OTTG MA Primary

Addresses

Primary practice location

575 Osgood St
North Andover, MA 01845-1975

Mailing address

575 Osgood St
North Andover, MA 01845-1975
Phone (978) 725-3300

Other names 1

  • The Meadows at Edgewood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060809000183 MA Part A Provider - Skilled Nursing Facility 4789687948 Practice locations: North Andover, MA

Skilled nursing facility certification: CCN 225724

Legal name
EDGEWOOD RETIREMENT COMMUNITY, INC.
Doing business as
THE MEADOWS
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Mar 4, 1997
Last certification
Sep 5, 2024
Beds
60
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 16, 1993 in MA
Enrollment address
575 Osgood St
North Andover, MA 01845-1975
Nursing home name
MEADOWS, THE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Meadows, TheCCN 225724
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Mar 4, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6036.5 residents per day on average

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
22D0921929Meadows of Edgewood, the575 Osgood St, North Andover, MA 01845Certificate of waiverNov 7, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Bryan Deveau Individual Corporate DirectorDirector of Finance Nov 19, 2018 100%
W-2 Managing EmployeeDirector of Finance Nov 19, 2018 100%
Michael Consoli Individual Corporate Director Jun 13, 2019
Eliott Hacker Individual Corporate DirectorBoard Member Jun 9, 2017
Hugo Overdeput Individual Corporate DirectorBoard Member Jun 9, 2020
Natalie Y Macbrien Individual Corporate DirectorDirector of Compliance Sep 10, 2019 100%
W-2 Managing EmployeeDirector of Compliance Aug 20, 2012 100%
Paul a Hedstrom Individual Corporate DirectorBoard Member Jun 9, 2017
Richard Sumberg Individual Corporate DirectorBoard Member Jun 9, 2020
Marlene Hoyt Individual Corporate DirectorBoard Member Jun 9, 2017
Melissa Kampersal Individual Corporate OfficerExecutive Director Jan 1, 2018 100%
Henry White Individual Corporate DirectorBoard Member Jun 9, 2020
Marlene Rotering Individual Corporate OfficerCeo May 1, 2012 100%
W-2 Managing EmployeeCeo May 1, 2012 100%
Timothy Vaill Individual Corporate DirectorBoard Chair Jun 9, 2017
Edgewood Retirement Community, Inc. Organization, North Andover, MA Non-profit 5% Or Greater Direct Ownership Interest May 20, 2010 100%
Donald Piccirillo Individual Corporate DirectorBoard Member Jun 9, 2017
Josh Young Individual Corporate DirectorResident Trustee Jun 13, 2019
Jane Sullivan Individual Corporate OfficerCfo Jun 1, 2014 100%
W-2 Managing EmployeeCfo May 20, 2010
Thomas Smith Individual Corporate DirectorBoard Member Jun 9, 2017
Elizabeth Barbadoro Individual Corporate DirectorResident Trustee Jun 9, 2020
Sayeeda Rahman Individual Corporate DirectorBoard Member Jun 9, 2017
Camille Miragliotta Individual Corporate DirectorBoard Member Jun 16, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659354355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 OSGOOD ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451975",
            "telephone_number": "978-725-3300",
            "fax_number": "978-725-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 OSGOOD ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451975",
            "telephone_number": "978-725-3300",
            "fax_number": "978-725-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD RETIREMENT COMMUNITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROTERING",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-725-3300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "OTTG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Meadows at Edgewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.