NPIMap

Organization Active NPI

County of Passaic Department of Finance

Doing business as Preakness Healthcare Center

  • Skilled Nursing Facility
  • Wayne, NJ
National Provider Identifier
1710968987
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
061617 Issued in NJ
Legal business name
COUNTY OF PASSAIC DEPARTMENT OF FINANCE
Doing business as
Preakness Healthcare Center
Practice address
305 Oldham Rd
Wayne, NJ 07470
Phone
(973) 585-2189
Fax
(973) 790-1903
NPI assigned
Nov 7, 2005
Last updated
Feb 23, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF PASSAIC DEPARTMENT OF FINANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Authorized official

Name
Thomas Gerard Williamson
Title
Fiscal Officer
Phone
(973) 585-2189

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 061617 NJ Primary

Addresses

Primary practice location

305 Oldham Rd
Wayne, NJ 07470

Mailing address

305 Oldham Rd
Wayne, NJ 07470
Phone (973) 585-2189

Other identifiers 1

IdentifierTypeStateIssuer
4497309MedicaidNJ

Other names 1

  • Preakness Healthcare Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120807000210 NJ Part A Provider - Skilled Nursing Facility 9739134206 Practice locations: Wayne, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710968987. Details of each certification follow.

Skilled nursing facility certification: CCN 315361

Legal name
COUNTY OF PASSAIC DEPARTMENT OF FINANCE
Doing business as
PREAKNESS HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 1, 1996
Last certification
Jan 22, 2025
Beds
406
Ownership / control type
County
Organization structure
GovernmentNon-profit
Incorporated
in NJ
Enrollment address
305 Oldham Rd
Wayne, NJ 07470-2208
Nursing home name
PREAKNESS HEALTHCARE CENTER

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Preakness Healthcare CenterCCN 315361 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Dec 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
406269.5 residents per day on average
Penalties (3 years)
1Fines totaling $15,646

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Preakness Hospital LTC6 organizations share this tax ID, including this one
Part of
Preakness Hospital LTC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

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.

NameRoleSinceShare
Thomas Williamson Individual Corporate OfficerFiscal Officer Jun 1, 2004
Lucinda Corrado Individual Operational/Managerial ControlExecutive Director Dec 1, 2006 100%
County of Passaic Department of Finance Organization, Wayne, NJ Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2017 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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.

Affiliated clinicians 3

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1710968987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 OLDHAM RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-585-2189",
            "fax_number": "973-790-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 OLDHAM RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-585-2189",
            "fax_number": "973-790-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF PASSAIC DEPARTMENT OF FINANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF PASSAIC DEPARTMENT OF FINANCE",
        "enumeration_date": "2005-11-07",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "FISCAL OFFICER",
        "authorized_official_telephone_number": "973-585-2189"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NJ",
            "license": "061617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4497309",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preakness Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.