Pezzelli Nursing Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

543 Issued in RI

Legal business name

PEZZELLI NURSING HOME, INC

Doing business as

Golden Crest Nursing Centre

Practice address

100 Smithfield Rd
North Providence, RI 02904-5311

Phone

(401) 353-1710

Fax

(401) 353-1618

NPI assigned

Sep 22, 2005

Last updated

Aug 22, 2020By 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. Paul M Pezzelli, NHA

Title

Administrator

Phone

(401) 353-1710

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• GOLDEN CREST NURSING CENTRE Doing business as

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831185198. Details of each certification follow.

• CCN 415029 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 415029

Legal name

PEZZELLI NURSING HOME, INC

Doing business as

GOLDEN CREST NURSING CENTRE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 17, 1969

Last certification

Sep 20, 2024

Beds

152

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 1, 1969 in RI

Enrollment address

100 Smithfield Rd
North Providence, RI 02904-5382

Nursing home name

GOLDEN CREST NURSING CENTRE

Listed as

Golden Crest Nursing CentreCCN 415029 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 17, 1969

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

152143.9 residents per day on average

Penalties (3 years)

2Fines totaling $70,868

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 6

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 1

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

• Akindele Majekodunmi, M.D., M.B.A

  • Internal Medicine Physician
  • North Andover, MA
  • NPI 1447411764

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• Mohammad Suhail, MD

  • Internal Medicine Physician
  • Lincoln, RI
  • NPI 1255694451

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831185198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMITHFIELD RD",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045311",
            "telephone_number": "401-353-1710",
            "fax_number": "401-353-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SMITHFIELD RD",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045311",
            "telephone_number": "401-353-1710",
            "fax_number": "401-353-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEZZELLI NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEZZELLI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-353-1710",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "543",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOLDEN CREST NURSING CENTRE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Helene Penza, MA CAGS ACS
• Kathryn Pereira, DPT
• Debra A Perry, CRNA
• Joshua J. Perry, P.T.
• Geoffrey David Peterson, PHARM.D
• Emily Rose Pezzullo
• Mariel K Phillip
• Alyssa Piampiano, SLP-CF
• Morgan Richard Pierce
• Lissa Pierre, FNP-C

• Skilled Nursing Facility in North Providence, RI
• Providers in North Providence, RI by specialty
• Skilled Nursing Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.