North Park Nursing Home, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NORTH PARK NURSING HOME, INC.

Practice address

700 Island Cottage Rd
Rochester, NY 14612-2312

Phone

(585) 368-6100

Fax

(585) 368-6110

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Amanda Teugeman

Title

Administrator , Nha

Phone

(585) 368-6105

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Edna Tina Wilson Living Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335769

Legal name

NORTH PARK NURSING HOME INC

Doing business as

EDNA TINA WILSON LIVING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 7, 1993

Last certification

Apr 11, 2025

Beds

120

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Feb 28, 1992 in NY

Enrollment address

700 Island Cottage Rd
Rochester, NY 14612-2312

Nursing home name

EDNA TINA WILSON LIVING CENTER

Affiliated entity

ROCHESTER REGIONAL HEALTH

Listed as

Edna Tina Wilson Living CenterCCN 335769

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Dec 7, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120115.6 residents per day on average

Chain

Rochester Regional Health5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

North Park Nursing Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• North Park Nursing Home

  • Home Health Agency
  • Rochester, NY
  • NPI 1033391719
  NPD tax ID
• North Park Nursing Home

  • Adult Day Care Clinic/Center
  • Rochester, NY
  • NPI 1699824847
  NPD tax ID
• North Park Nursing Home, Inc.

  • Home Delivered Meals
  • Rochester, NY
  • NPI 1093253601
  NPD tax ID

All disclosed owners & managing parties 22

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Karan Singh Alag, M.D.

  • Hospitalist Physician
  • Rochester, NY
  • NPI 1245560093

  Corporate Director

  CMS ownership
• Marcy C Mulconry, MD

  • Obstetrics & Gynecology Physician
  • Rochester, NY
  • NPI 1922017433

  Corporate Director

  CMS ownership

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• North Park Nursing Home

  • Home Health Agency
  • Rochester, NY
  • NPI 1033391719
  NPPES parent name
• North Park Nursing Home

  • Adult Day Care Clinic/Center
  • Rochester, NY
  • NPI 1699824847
  NPPES parent name
• North Park Nursing Home, Inc.

  • Home Delivered Meals
  • Rochester, NY
  • NPI 1093253601
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert F. Devlin, DO

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1457394413
  NPD (past)
• Brian Hoon Son, D.O.

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1750671301
  NPD (past)

Affiliated clinicians 2

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

• Albert F. Devlin, DO

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1457394413

  Nursing home

  Care Compare affiliation
• Brian Hoon Son, D.O.

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1750671301

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1811044522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ISLAND COTTAGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122312",
            "telephone_number": "585-368-6100",
            "fax_number": "585-368-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ISLAND COTTAGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122312",
            "telephone_number": "585-368-6100",
            "fax_number": "585-368-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PARK NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "TEUGEMAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR , NHA",
        "authorized_official_telephone_number": "585-368-6105"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447869",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "NH620",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD BLUE CHOICE",
            "identifier": "0150059ET",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edna Tina Wilson Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serena Marie Norris, MHC
• Lisa H Norsen, NP
• North Park Nursing Home
• North Park Nursing Home
• North Park Nursing Home, Inc.
• Sarah Jo North, RN
• Northeast Pain Solutions
• Northland Hearing Centers, Inc.
• Caroline Northrup, RN
• Christine R Northrup, NP

• Skilled Nursing Facility in Rochester, NY
• Providers in Rochester, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.