Marycrest Manor

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

910000079 Issued in CA

Legal business name

MARYCREST MANOR

Practice address

10664 Saint James Drive
Culver City, CA 90230

Phone

(310) 838-2778

Fax

(310) 838-9647

NPI assigned

Sep 6, 2005

Last updated

Dec 18, 2012By 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

Veronica Maldonado

Title

Administrator

Phone

(310) 838-2778

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932193984. Details of each certification follow.

• CCN 055196 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 055196

Legal name

MARYCREST MANOR

Doing business as

MOUNT CARMEL HEALTH MINISTRIES

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1967

Last certification

Feb 16, 2025

Beds

57

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 11, 1956 in CA

Enrollment address

10664 Saint James Dr
Culver City, CA 90230-5461

Nursing home name

MARYCREST MANOR

Listed as

Marycrest ManorCCN 055196 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 1, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5745.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 35

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.

• Vincent D Nguyen, D.O.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Newport Beach, CA
  • NPI 1073603361

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

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

• Yulionas Gayauskas, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1487668836

  Nursing home

  Care Compare affiliation
• Paul Leitner, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Los Angeles, CA
  • NPI 1912093865

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1932193984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10664 SAINT JAMES DRIVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-838-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10664 SAINT JAMES DRIVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90230",
            "telephone_number": "310-838-2778",
            "fax_number": "310-838-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYCREST MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-838-2778"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000079",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05196F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Martinon
• Maria Delores Martinson
• Michelle Theresa Mary Martonick
• Kersti Marusich, DPT
• Mary Mountain Home Care LLC
• Stephen Tyler Mascaro
• Sarita Aludor Maskall
• Lusine Maslakyan, MSW
• Felesia Lagale Mason
• Mass Mental Health Foundation

• Skilled Nursing Facility in Culver City, CA
• Providers in Culver City, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.

Verify at the official NPI Registry.