Mary Elizabeth Nursing Center Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1068-C Issued in CT

Legal business name

MARY ELIZABETH NURSING CENTER INC.

Practice address

28 Broadway
Mystic, CT 06355-2833

Phone

(860) 536-9655

Fax

(860) 536-4571

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Vess

Title

Cfo

Phone

(860) 678-9755

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679603732. Details of each certification follow.

• CCN 075327 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 075327

Legal name

MARY ELIZABETH NURSING CENTER. INC.

Doing business as

APPLE REHAB MYSTIC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1990

Last certification

Aug 13, 2024

Beds

60

Ownership / control type

Corporation

Multi-facility organization

APPLE REHAB CARE

Organization structure

CorporationProprietary

Incorporated

Jul 23, 1984 in CT

Enrollment address

28 Broadway Ave
Mystic, CT 06355-2833

Nursing home name

APPLE REHAB MYSTIC

Affiliated entity

APPLE REHAB

Listed as

Apple Rehab MysticCCN 075327 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jan 1, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6055.7 residents per day on average

Chain

Apple Rehab20 facilities in the chain

Penalties (3 years)

1Fines totaling $16,588

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 3

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

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1679603732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 BROADWAY AVE",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552833",
            "telephone_number": "860-536-9655",
            "fax_number": "860-536-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 BROADWAY",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552833",
            "telephone_number": "860-536-9655",
            "fax_number": "860-536-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ELIZABETH NURSING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "VESS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-678-9755",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "1068-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010637",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Manferdini, PHARM.D.
• Suzanne Manzo, PT
• Kathleen Fitzgerald Maranda, MS
• Madison Marcavage, LPCA
• Jennifer Anne Martley, LCSW
• Cynthia Lou Masonjones, L.C.S.W.
• Cory Mastrandrea
• Gray McCaffery, FNP-BC
• Sarah McCoy
• Shaina McGinity

• Skilled Nursing Facility in Mystic, CT
• Providers in Mystic, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2016; 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.