Masonic Healthcare Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

119-C Issued in CT

Legal business name

MASONIC HEALTHCARE CENTER

Practice address

22 Masonic Ave
Wallingford, CT 06492-3048

Phone

(203) 679-6928

Fax

(203) 679-5970

NPI assigned

Jun 16, 2005

Last updated

Mar 7, 2023By 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

Mr. Martin G Deflorio, R.PH.

Title

Director of Pharmacy

Phone

(203) 679-6928

Specialties & licenses 2

Addresses

Other names 1

• PHARMACY DEPARTMENT Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Cardiology Department5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Masonicare Health Center

  • Skilled Nursing Facility
  • Wallingford, CT
  • NPI 1235500497
  NPD tax ID
• Masonicare Health Center

  • Skilled Nursing Facility
  • Wallingford, CT
  • NPI 1265425136
  NPD tax ID
• Masonicare Health Center

  • Nursing Facility/Intermediate Care Facility
  • Wallingford, CT
  • NPI 1356558472
  NPD tax ID
• Masonicare Health Center

  • Prosthetic/Orthotic Supplier
  • Wallingford, CT
  • NPI 1427250885
  NPD tax ID

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1780689836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-679-6928",
            "fax_number": "203-679-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-679-6928",
            "fax_number": "203-679-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC HEALTHCARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DEFLORIO",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "203-679-6928",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "119-C",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "119C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMACY DEPARTMENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jenny D Martin, LMSW
• Laura M Martineau, OTR
• Annemieke Ausloos Martino, PT, DPT
• Casey Martins, AUD
• Stacey L. Martwinski-Nardozzi, MSW
• Masonicare
• Masonicare
• Masonicare
• Masonicare Behavioral Health, LLC
• Masonicare Health Center

• Skilled Nursing Facility in Wallingford, CT
• Providers in Wallingford, 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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.