Active NPI
Margaret Anna Cusack Care Center,Inc
- Skilled Nursing Facility
- Jersey City, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 030905
- Legal business name
- MARGARET ANNA CUSACK CARE CENTER,INC
- Practice address
- 537 Pavonia Ave
Jersey City, NJ 07306-1803 - Phone
- (201) 653-8300
- Fax
- (201) 653-7705
- NPI assigned
- Mar 26, 2007
- Last updated
- Aug 22, 2020
- 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
- Ann Taylor, L.N.H.A.
- Title
- Administrator
- Phone
- (201) 653-8300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 030905 | NJ | Primary |
Addresses
Primary practice location
537 Pavonia Ave
Jersey City, NJ 07306-1803
Mailing address
537 Pavonia Avenue
Jersey City, NJ 07306
Phone (201) 653-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4479904 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070424000512 | NJ | Part A Provider - Skilled Nursing Facility | 8729183520 | Practice locations: Jersey City, NJ |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1699892315. Details of each certification follow.
Skilled nursing facility certification: CCN 315452
- Legal name
- MARGARET ANNA CUSACK CARE CENTER,INC
- Doing business as
- PEACE CARE ST. JOSEPH'S
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1997
- Last certification
- Nov 7, 2024
- Beds
- 139
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 537 Pavonia Avenue
Margaret Anna Cusack Care Center
Jersey City, NJ 07306-1803 - Nursing home name
- PEACE CARE ST JOSEPH'S
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Peace Care St Joseph's
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Dec 1, 1997
- Medicare certification status
- Active
- Certified beds
- 139
- Penalties (3 years)
- 22
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2189821 | Peace Care St Joseph's | Certificate of waiver | Aug 5, 2026 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- alexr@meddirect.cusackcarecenter.org
- deborahp@meddirect.cusackcarecenter.org
- ernestcj@meddirect.cusackcarecenter.org
- monad@meddirect.cusackcarecenter.org
Ownership & related parties
All disclosed owners & managing parties 17
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 |
|---|---|---|---|
| Adp of the SNF | Aug 23, 2024 | ||
| Silvana Buccianti | Corporate Officer | Jul 1, 2024 | |
| Managing Control - Governing Body | Jul 1, 2018 | ||
| Trustee of the SNF | Jul 1, 2018 | ||
| Adp of the SNF | Jan 11, 2023 | ||
| Peace Care Inc | 5% Or Greater Direct Ownership Interest | Jun 1, 2016 | 100% |
| Elizabeth Doren | Corporate Officer | Jul 1, 2024 | |
| Managing Control - Governing Body | Jul 1, 2018 | ||
| Trustee of the SNF | Jul 1, 2018 | ||
| Adp of the SNF | Feb 24, 2025 | ||
| Teresa Donohue | Corporate Officer | Jun 30, 2024 | |
| Managing Control - Governing Body | Mar 28, 2016 | ||
| Trustee of the SNF | Mar 28, 2016 | ||
| Adp of the SNF | Sep 30, 2020 | ||
| Adp of the SNF | Apr 10, 2024 | ||
| Kyle S Hreben | Corporate Officer | Jul 1, 2022 | |
| Operational/Managerial Control | Jul 1, 2022 | ||
| Adp of the SNF | Jul 1, 2022 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Adp of the SNF | Feb 15, 2022 | ||
| Peace Ministries Inc | 5% Or Greater Indirect Ownership Interest | Jun 1, 2016 | 100% |
| Operational/Managerial Control | Jun 1, 2016 | ||
| Donald E. Lynch | Corporate Officer | Oct 1, 2022 | |
| Operational/Managerial Control | Oct 1, 2022 | ||
| Adp of the SNF | Sep 30, 2020 | ||
| Adp of the SNF | Mar 1, 2025 | ||
| Adp of the SNF | Feb 5, 2024 |
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Jersey City, NJ
- NPI 1679572960
Peace Care Inc, Peace Ministries Inc
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Doula
- East Orange, NJ
- NPI 1104199801
-
- Nephrology Physician
- Jersey City, NJ
- NPI 1962509265
-
- Internal Medicine Physician
- Jersey City, NJ
- NPI 1144589730
Affiliated clinicians 10
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physical Medicine & Rehabilitation Physician
- Bayonne, NJ
- NPI 1447261276
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Bayonne, NJ
- NPI 1346285079
Nursing home
-
- Physical Medicine & Rehabilitation Physician
- Hoboken, NJ
- NPI 1336228279
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699892315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 PAVONIA AVENUE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "07306",
"telephone_number": "201-653-8300",
"fax_number": "201-653-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 PAVONIA AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073061803",
"telephone_number": "201-653-8300",
"fax_number": "201-653-7705"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARGARET ANNA CUSACK CARE CENTER,INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TAYLOR",
"authorized_official_first_name": "ANN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "201-653-8300",
"authorized_official_credential": "L.N.H.A."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NJ",
"license": "030905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4479904",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.