Bishop Wicke Health and Rehabilitation Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

812C Issued in CT

Legal business name

BISHOP WICKE HEALTH AND REHABILITATION CENTER INC

Practice address

580 Long Hill Ave
Shelton, CT 06484-4803

Phone

(120) 394-4828

NPI assigned

Feb 28, 2007

Last updated

Jul 16, 2015By 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

David Lawlor

Title

President

Phone

(203) 944-8285

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851428387. Details of each certification follow.

• CCN 075163 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 075163

Legal name

BISHOP WICKE HEALTH AND REHABILITATION CENTER INC

Doing business as

MASONICARE AT BISHOP WICKE HEALTH CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 14, 1968

Last certification

Feb 21, 2024

Beds

120

Ownership / control type

Nonprofit Corporation

Multi-facility organization

MASONICARE HEALTH CENTER

Organization structure

CorporationNon-profit

Enrollment address

584 Long Hill Ave
Shelton, CT 06484-4810

Nursing home name

MASONICARE AT BISHOP WICKE HEALTH & REHABILITATION CENTER, INC

Listed as

Masonicare at Bishop Wicke Health & RehabilitationCCN 075163 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jun 14, 1968

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120111.8 residents per day on average

Penalties (3 years)

1Fines totaling $8,018

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Bishop Wicke3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Bishop Wicke

  • Skilled Nursing Facility
  • Shelton, CT
  • NPI 1558351247
  NPD tax ID
• Care Link Corp

  • Assisted Living Facility
  • Shelton, CT
  • NPI 1902099492
  NPD tax ID

All disclosed owners & managing parties 5

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Masonicare Health Center

  • Psychiatric Hospital
  • Wallingford, CT
  • NPI 1174516041

  Masonicare Inc

  CMS ownership
• Masonicare Health Center

  • Skilled Nursing Facility
  • Wallingford, CT
  • NPI 1265425136

  Masonicare Inc

  CMS ownership

Affiliated clinicians 4

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

• Marina Blagodatny, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Stratford, CT
  • NPI 1447291497

  Nursing home

  Care Compare affiliation
• Lynne Hillis, M.D.

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1558367359

  Nursing home

  Care Compare affiliation
• Daniel Eric Wollman, M.D, PHD

  • Geriatric Medicine (Internal Medicine) Physician
  • Shelton, CT
  • NPI 1659344596

  Nursing home

  Care Compare affiliation
• Lena Wu Rivas, M.D.

  • Internal Medicine Physician
  • Milford, CT
  • NPI 1679806046

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1851428387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 LONG HILL AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 LONG HILL AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844803",
            "telephone_number": "120-394-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISHOP WICKE HEALTH AND REHABILITATION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "LAWLOR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "12039448285"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "812C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00008128",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luceidy Kyani Billini
• Trisdan Binan
• Robin Biondo, PTA
• Birch Meadow Health PC
• Bishop Wicke
• Ballard Glenn Blair, D.P.M
• Shakeya Tyneice Blakes
• Samantha Blazer
• Mark H Blechner, M.D.
• Bloom Wellness Center

• Skilled Nursing Facility in Shelton, CT
• Providers in Shelton, 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 Jul 16, 2015; 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.