Organization Active NPI

Long Term Centers of Lexington Inc

  • Skilled Nursing Facility
  • Lexington, MA
National Provider Identifier
1730167990
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0205 Issued in MA
Legal business name
LONG TERM CENTERS OF LEXINGTON INC
Doing business as
Pine Knoll Nursing Center
Practice address
30 Watertown St
Lexington, MA 02421-6399
Phone
(781) 862-8151
Fax
(781) 862-3703
NPI assigned
Jan 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Thomas E Woods
Title
Administrator
Phone
(781) 862-8151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0205 MA Primary

Addresses

Primary practice location

30 Watertown St
Lexington, MA 02421-6399

Mailing address

30 Watertown St
Lexington, MA 02421-6399
Phone (781) 862-8151

Other identifiers 1

IdentifierTypeStateIssuer
0925799MedicaidMA

Other names 1

  • Pine Knoll Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100108000205 MA Part A Provider - Skilled Nursing Facility 2860582830 Practice locations: Lexington, MA

Skilled nursing facility certification: CCN 225049

Legal name
LONG TERM CENTERS OF LEXINGTON INC
Doing business as
PINE KNOLL NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Sep 26, 2024
Beds
81
Ownership / control type
Corporation
Multi-facility organization
Long Term Centers of New England, Inc.
Organization structure
CorporationProprietary
Incorporated
Dec 1, 1999 in MA
Enrollment address
30 Watertown St
Lexington, MA 02421-6331
Nursing home name
PINE KNOLL NURSING CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pine Knoll Nursing CenterCCN 225049 · All quality measures
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8169.4 residents per day on average
Special focus status
SFF
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
3Fines totaling $454,052

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
22D0725098Pine Knoll Nursing Center30 Watertown Street, Lexington, MA 02421Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Thomas E Woods Individual 5% Or Greater Direct Ownership Interest Jul 25, 2024 75%
Corporate OfficerPresident/Ceo Dec 1, 1999 75%
Operational/Managerial Control May 1, 2018
Adp of the SNF May 1, 2018
Matthew J Sweeney Individual 5% Or Greater Direct Ownership Interest Jul 25, 2024 25%
Corporate OfficerClerk/Coo Jul 31, 2024 25%
Operational/Managerial Control May 1, 2018
Adp of the SNF May 1, 2018
Asif Merchant Individual Operational/Managerial Control Jan 1, 2014
Adp of the SNF Jan 1, 2014
Jessica Gouveia Individual Operational/Managerial Control Aug 1, 2024
Adp of the SNF Aug 1, 2024

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.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1730167990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WATERTOWN ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024216399",
            "telephone_number": "781-862-8151",
            "fax_number": "781-862-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WATERTOWN ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024216399",
            "telephone_number": "781-862-8151",
            "fax_number": "781-862-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TERM CENTERS OF LEXINGTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "781-862-8151"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0925799",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Knoll Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.