Mystic Healthcare & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

839-C Issued in CT

Legal business name

MYSTIC HEALTHCARE & REHABILITATION CENTER LLC

Doing business as

Mystic Manor

Practice address

475 High Street
Mystic, CT 06355

Phone

(860) 536-6070

Fax

(860) 536-9480

NPI assigned

May 12, 2006

Last updated

Aug 26, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin Sbriglio

Title

Ceo

Phone

(203) 381-1327

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mystic Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780635938. Details of each certification follow.

• CCN 075271 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 075271

Legal name

MYSTIC HEALTHCARE & REHABILITATION CENTER LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1976

Last certification

Nov 8, 2023

Beds

100

Ownership / control type

Limited Liability Corporation

Multi-facility organization

RYDERS HEALTH MANAGEMENT

Organization structure

LLCProprietary

Incorporated

Apr 21, 2006 in CT

Enrollment address

475 High St
Mystic, CT 06355-1707

Nursing home name

MYSTIC HEALTHCARE & REHABILITATION CENTER, LLC

Affiliated entity

RYDERS HEALTH MANAGEMENT

Listed as

Mystic Healthcare & Rehabilitation Center, LLCCCN 075271 · All quality measures

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 - Limited Liability company

Certified

Aug 1, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10090.3 residents per day on average

Chain

Ryders Health Management7 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $38,860

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 2

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.

• Vikram Rao, M.D.

  • Internal Medicine Physician
  • West Haven, CT
  • NPI 1427439249

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1780635938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 HIGH STREET",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-536-6070",
            "fax_number": "860-536-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 HIGH STREET",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-536-6070",
            "fax_number": "860-536-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC HEALTHCARE & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "SBRIGLIO",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-381-1327"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "839-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000008391",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mystic Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James B Moss III, MD
• Christine L. Murray
• Mystic Bridge to Wellness, LLC
• Mystic Dental Group, P.C.
• Mystic Geriatrics, LLC
• Mystic Healthcare and Rehabilitation Facility
• Mystic Medical Associates LLC
• Mystic Medical Group, PC
• Mystic River Ambulance Association, Inc
• Mystic Services, LLC (Mystic Bridge to Wellness)

• Skilled Nursing Facility in Mystic, CT
• Providers in Mystic, 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 Aug 26, 2014; 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.