Senior Residential Care/Worcester, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0723 Issued in MA

Legal business name

SENIOR RESIDENTIAL CARE/WORCESTER, INC.

Doing business as

Wingate at Worcester

Practice address

59 Acton St
Worcester, MA 01604-4829

Phone

(508) 791-3147

Fax

(508) 753-6267

NPI assigned

May 9, 2006

Last updated

Oct 21, 2014By 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

Ms. Tamilyn M. Levin, ESQ.

Title

Cfo

Phone

(781) 707-9510

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 1

• Wingate at Worcester Doing business as

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1962451542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 KENDRICK ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942708",
            "telephone_number": "781-707-9085",
            "fax_number": "781-707-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ACTON ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044829",
            "telephone_number": "508-791-3147",
            "fax_number": "508-753-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR RESIDENTIAL CARE/WORCESTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "TAMILYN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "781-707-9510",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0723",
            "primary": true
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "MA",
            "license": "0723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880373",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312074",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026673A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30103097",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068047",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880364",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000026450",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026673B",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02998176",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wingate at Worcester",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Jackson Selly, NP
• Rita J Semaan
• Anevia Semiday
• Laureen Sena, MD
• Fnu Senin, MD
• Alison Senior, M.S., BCBA, LABA
• Patricia M. Senior, RNCS
• Paul Senn, ED.M
• Ethan M Senser, M.D.
• Prasiddha Senthil Kumar, MD

• Skilled Nursing Facility in Worcester, MA
• Providers in Worcester, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.