Active NPI
Eastside Retirement Association
- Skilled Nursing Facility
- Redmond, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- EASTSIDE RETIREMENT ASSOCIATION
- Practice address
- 10901 176TH Circle NE
Redmond, WA 98052-7218 - Phone
- (425) 556-8100
- Fax
- (425) 556-8104
- NPI assigned
- Sep 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa A. Hardy
- Title
- President and Ceo
- Phone
- (425) 556-8100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1113 | WA | |
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
10901 176TH Circle NE
Redmond, WA 98052-7218
Mailing address
10901 176TH Circle NE
Redmond, WA 98052-7218
Phone (425) 556-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41-111-34 | Medicaid | WA |
Other names 1
- Corwin Center at Emerald Heights
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111109000178 | WA | Part A Provider - Skilled Nursing Facility | 8022175983 | Practice locations: Redmond, WA |
Skilled nursing facility certification: CCN 505478
- Legal name
- EASTSIDE RETIREMENT ASSOCIATION
- Doing business as
- CORWIN CENTER AT EMERALD HEIGHTS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 8, 1992
- Last certification
- Apr 23, 2025
- Beds
- 61
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Emerald Communities
- Organization structure
- Corporation
- Enrollment address
- 10901 176TH Cir NE
Redmond, WA 98052-7218 - Nursing home name
- CORWIN CENTER AT EMERALD HEIGHTS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Corwin Center At Emerald Heights
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Dec 8, 1992
- Medicare certification status
- Active
- Certified beds
- 61
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0866827 | Emerald Heights | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Jamilyn Bloodworth | Operational/Managerial Control | Nov 1, 2023 | |
| Adp of the SNF | Nov 1, 2023 | ||
| Masoud S Taleghani | Operational/Managerial Control | Oct 1, 2024 | |
| Adp of the SNF | Oct 1, 2024 | ||
| Corey Weisner | Corporate Director | Oct 14, 2024 | |
| Adp of the SNF | Oct 14, 2024 | ||
| Craig Comfort | Corporate Director | Jan 4, 2016 | |
| Adp of the SNF | Jan 4, 2016 | ||
| Michelle Wood | Corporate Officer | Apr 17, 2023 | |
| Adp of the SNF | Apr 17, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1114117330
Adp of the SNF, Operational/Managerial Control
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Primary Care Clinic/Center
- Redmond, WA
- NPI 1619122934
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Seattle, WA
- NPI 1114117330
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Kirkland, WA
- NPI 1053450627
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1326931200000",
"number": "1861597205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10901 176TH CIRCLE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980527218",
"telephone_number": "425-556-8100",
"fax_number": "425-556-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10901 176TH CIRCLE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980527218",
"telephone_number": "425-556-8100",
"fax_number": "425-556-8104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EASTSIDE RETIREMENT ASSOCIATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-13",
"last_updated": "2012-01-19",
"status": "A",
"authorized_official_last_name": "HARDY",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "425-556-8100"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WA",
"license": "1113",
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41-111-34",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Corwin Center at Emerald Heights",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Redmond, WA
- Grace Elizabeth Cotay Dy
- Dynacare Northwest, Inc
- Dynamic Chiropractic Clinic of Bellevue PLLC
- Eastside Emergency Physicians, PLLC
- Eastside Retirement Association
- Eastside Therapy and Consultation
- Marshall H, Eaton, M.D.
- Jordan Eble, ACE/CPT, CIFT/NCPAD
- Colby A Eckland, D.D.S.
- Wilhelm Bruno Von Eckroth
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.