Active NPI
Edgar P Benjamin Healthcare Center, Inc
- Skilled Nursing Facility
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0785
- Legal business name
- EDGAR P BENJAMIN HEALTHCARE CENTER, INC
- Practice address
- 120 Fisher Avenue
Boston, MA 02120-3320 - Phone
- (617) 738-1500
- Fax
- (617) 738-6472
- NPI assigned
- Oct 14, 2005
- 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
- Ms. Myrna E. Wynn, PRESIDENT & CEO
- Title
- Administrator
- Phone
- (617) 738-1500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0785 | MA | Primary |
Addresses
Primary practice location
120 Fisher Avenue
Boston, MA 02120-3320
Mailing address
120 Fisher Avenue
Boston, MA 02120-3320
Phone (617) 738-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0998613 | Medicaid | MA |
Other names 1
- Benjamin Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111220000364 | MA | Part A Provider - Skilled Nursing Facility | 8123147832 | Practice locations: Boston, MA |
Skilled nursing facility certification: CCN 225654
- Legal name
- EDGAR P BENJAMIN HEALTHCARE CENTER, INC
- Doing business as
- BENJAMIN HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1995
- Last certification
- Apr 30, 2025
- Beds
- 205
- Ownership / control type
- Individual
- Organization structure
- Corporation
- Incorporated
- May 4, 1927 in MA
- Enrollment address
- 120 Fisher Ave
Boston, MA 02120-3320 - Nursing home name
- BENJAMIN HEALTHCARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Benjamin Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Jan 1, 1995
- Medicare certification status
- Active
- Certified beds
- 205
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Joseph D Feaster | Corporate Director | Apr 3, 2024 | |
| Operational/Managerial Control | Apr 3, 2024 | ||
| Delicia Mark | Corporate Officer | May 28, 2024 | |
| Operational/Managerial Control | May 28, 2024 | ||
| Kenya Hanspard | Operational/Managerial Control | Jul 2, 2024 | |
| Adp of the SNF | May 21, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Hospitalist Physician
- Burlington, MA
- NPI 1932170305
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hospitalist Physician
- Burlington, MA
- NPI 1932170305
-
- Geriatric Medicine (Internal Medicine) Physician
- Boston, MA
- NPI 1225002603
-
- Internal Medicine Physician
- Boston, MA
- NPI 1780871970
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329350400000",
"number": "1962491704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 FISHER AVENUE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203320",
"telephone_number": "617-738-1500",
"fax_number": "617-738-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 FISHER AVENUE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203320",
"telephone_number": "617-738-1500",
"fax_number": "617-738-6472"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDGAR P BENJAMIN HEALTHCARE CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-14",
"last_updated": "2012-02-16",
"status": "A",
"authorized_official_last_name": "WYNN",
"authorized_official_first_name": "MYRNA",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "617-738-1500",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "PRESIDENT & CEO"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MA",
"license": "0785",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0998613",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Benjamin Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.