Northwood Ma SNF LLC
Organization Active NPI Skilled Nursing Facility · Lowell, MA
NPI 1760426282 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1760426282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0838 (MA)
- Legal business name
- NORTHWOOD MA SNF LLC
- Practice address
- 1010 Varnum Avenue
Lowell, MA 01854 - Phone
- (978) 458-8773
- Fax
- (978) 458-6366
- NPI assigned
- Jun 15, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ATHENA HEALTH CARE ASSOCIATES, INC
Authorized official
- Name
- Lawrence G. Santilli
- Title
- Manager
- Phone
- (860) 751-3900
Facilities with the same owner 25
Practitioners 3
-
Zaheer Ahmed, M.D.
-
Michael G Bertos, M.D.
-
Udayasena Reddy Dendi, M.D.
Affiliated clinicians 2
-
Zaheer Ahmed, M.D.
-
Udayasena Reddy Dendi, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Northwood Rehabilitation & Healthcare Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Feb 17, 1987
- Medicare certification status
- Active
- Certified beds
- 123 · 115.3 residents per day on average
- Chain
- Athena Healthcare Systems
- Penalties (3 years)
- 1 · fines totaling $85,178
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0875461 | Northwood Ma SNF Dba Northwood Rehab | Certificate of waiver | Aug 22, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Skilled nursing facility certification: CCN 225298
- Legal name
- NORTHWOOD MA SNF LLC
- Doing business as
- NORTHWOOD REHABILITATION & HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 17, 1987
- Last certification
- Aug 29, 2024
- Beds
- 123
- Ownership / control type
- Partnership
- Multi-facility organization
- Athena Health Care Systems
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 1, 2012 in MA
- Enrollment address
- 1010 Varnum Avenue
Lowell, MA 01854-1915 - Nursing home name
- NORTHWOOD REHABILITATION & HEALTHCARE CENTER
- Affiliated entity
- ATHENA HEALTHCARE SYSTEMS
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Lawrence E Santilli |
5% Or Greater Indirect Ownership Interest | Sep 1, 2012 | 6% |
| Michael E Mosier |
5% Or Greater Indirect Ownership Interest | Sep 1, 2012 | 6% |
| W-2 Managing Employee | Sep 1, 2012 | ||
| Athena Health Care Associates, Inc. |
Operational/Managerial Control | Sep 1, 2012 | |
| Lorrie Rezendes |
5% Or Greater Indirect Ownership Interest | Sep 1, 2012 | 2.5% |
| Valerie Chakalos-Santilli |
5% Or Greater Indirect Ownership Interest | Sep 1, 2012 | 5% |
| Lawrence G Santilli |
5% Or Greater Indirect Ownership Interest |
May 4, 2020 | 73.5% |
| Corporate Officer |
Oct 3, 2019 | ||
| Diane Curtis |
5% Or Greater Indirect Ownership Interest | Sep 1, 2012 | 3% |
| Athena Health Care Systems Ma R LLC |
5% Or Greater Direct Ownership Interest | Sep 1, 2012 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120926000081 | MA | Part a Provider - Skilled Nursing Facility | 8820247471 | Practice locations: Lowell, MA |
National Provider Directory
- Part of
- Athena Health Care Associates Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0838 | MA | Yes |
Addresses
Primary practice location
1010 Varnum Avenue
Lowell, MA 01854
Mailing address
1010 Varnum Ave
Lowell, MA 01854-1915
Phone (508) 879-4050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110094540A | Medicaid | MA | |
| 2222529801 | Other | MA | BC/BS OF MA PROVIDER NUMB |
| 907339 | Other | MA | HARVARD PILGRIM PROV NUMB |
| 914985 | Other | MA | TUFTS MEDICARE PREFERRED |
| 249 | Other | MA | FALLON VENDOR CODE |
| 7100155 | Other | MA | EVERCARE PROV # |
Other names
- Northwood Rehabilitation & Health Care Center
Other providers in Lowell, MA
- Darren E. Nordin
- Christina Norman
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- Northeast Medical Group, Inc.
- Northeast Medical Group, Inc.
- Angellina Nou
- Andrew James Nowalk
- Mariam Nsimbi
- Simon Peter Nsubuga
- Kristin Nuckols
All providers in Lowell, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.