Crossroads Care Center of Weyauwega, LLC
Organization Active NPI Skilled Nursing Facility · Weyauwega, WI
NPI 1851784334 · NPPES record last updated Jun 9, 2026
Key facts
- NPI
- 1851784334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CROSSROADS CARE CENTER OF WEYAUWEGA, LLC
- Practice address
- 717 E Alfred St
Weyauwega, WI 54983-9024 - Phone
- (920) 867-3121
- Fax
- (920) 867-3997
- NPI assigned
- Mar 9, 2015
- Organization subpart
- No
Authorized official
- Name
- David Merzel
- Title
- Cfo
- Phone
- (847) 983-4860
Owners & managing parties with NPI records 1
-
Sarfraz Singh Sidhu, M.D.
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Avina of Weyauwega
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Aug 1, 1984
- Medicare certification status
- Active
- Certified beds
- 84 · 51.9 residents per day on average
- Chain
- Avina Healthcare
- Penalties (3 years)
- 5 · fines totaling $116,270
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0398008 | Crossroads Care Center of Weyauwega | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525315
- Legal name
- CROSSROADS CARE CENTER OF WEYAUWEGA LLC
- Doing business as
- AVINA OF WEYAUWEGA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 1, 1984
- Last certification
- Apr 17, 2025
- Beds
- 84
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- May 1, 2015
- Organization structure
- LLC · Proprietary
- Enrollment address
- 717E Alfred St
Weyauwega, WI 54983-9024 - Nursing home name
- AVINA OF WEYAUWEGA
- Affiliated entity
- AVINA HEALTHCARE
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Sarfraz Sidhu |
Operational/Managerial Control | Oct 1, 2021 | |
| Adp of the SNF | Oct 1, 2021 | ||
| Aa Healthcare Management, LLC |
Operational/Managerial Control | May 1, 2015 | |
| Rebecca Kern |
Operational/Managerial Control | Sep 30, 2015 | |
| Adp of the SNF | Sep 30, 2015 | ||
| Aaron Topper |
5% Or Greater Direct Ownership Interest | May 1, 2015 | 50% |
| Operational/Managerial Control |
May 1, 2015 | ||
| Joseph Brandman |
5% Or Greater Direct Ownership Interest | May 1, 2015 | 50% |
| Operational/Managerial Control |
May 1, 2015 | ||
| Managing Control - Governing Body |
May 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150716003350 | WI | Part a Provider - Skilled Nursing Facility | 6305159526 | Practice locations: Weyauwega, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
717 E Alfred St
Weyauwega, WI 54983-9024
Mailing address
717 E Alfred St
Weyauwega, WI 54983-9024
Phone (920) 867-3121
Other names
- Avina of Weyauwega
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Weyauwega, WI
- Luke Derek Casona Berdin
- Kimberly Brundidge
- Roy Buchholz
- Theresa Ellen Cane-Petersen
- County of Waupaca
- Michelle Ann Dean
- Brian Domrzalski
- Extendicare Homes, Inc.
- Craig M Gorst
- Victoria Hillskotter
All providers in Weyauwega, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.