CT Watermark 3030, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2430 Issued in CT

Legal business name

CT WATERMARK 3030, LLC

Practice address

3030 Park Ave
Bridgeport, CT 06604-1138

Phone

(203) 374-5611

Fax

(203) 374-2871

NPI assigned

Jun 24, 2016

Organization subpart

No

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

Authorized official

Name

Greta Frazier

Title

Director

Phone

(520) 797-4000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Skilled nursing facility certification: CCN 075440

Legal name

CT WATERMARK 3030 LLC

Doing business as

THE SPRINGS AT 3030 PARK

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

May 8, 2009

Last certification

Feb 11, 2025

Beds

23

Ownership / control type

Limited Liability Corporation

Multi-facility organization

WATERMARK RETIREMENT

Organization structure

LLCProprietary

Incorporated

Jan 14, 2016 in DE

Enrollment address

3030 Park Ave
Bridgeport, CT 06604-1138

Nursing home name

SPRINGS AT 3030 PARK, THE

Listed as

Springs at 3030 Park, theCCN 075440

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare

Ownership

For profit - Limited Liability company

Certified

May 8, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2321.2 residents per day on average

Penalties (3 years)

1Fines totaling $8,018

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 9

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rahul Gupta, M.D.

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1245421213

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1720439391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W RUDASILL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047800",
            "telephone_number": "520-797-4000",
            "fax_number": "520-797-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041138",
            "telephone_number": "203-374-5611",
            "fax_number": "203-374-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT WATERMARK 3030, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-797-4000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissette I Cruz, PA-C
• Alexander Crystal, M.D
• CT ABA Services
• CT Braces Bridgeport Orthodontics PC
• CT Braces, LLC
• Marcela Juliana Cuellar Lobo, MD
• Marlene Cuevas
• Bianca Cummings
• Luciene Coretta Cummings
• Evelia Cumpa, RDH

• Skilled Nursing Facility in Bridgeport, CT
• Providers in Bridgeport, 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 Jun 24, 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.