Organization Active NPI

Edgar P Benjamin Healthcare Center, Inc

  • Skilled Nursing Facility
  • Boston, MA
National Provider Identifier
1962491704
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0785 Issued in MA
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

Updated by the provider on Feb 16, 2012

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0998613MedicaidMA

Other names 1

  • Benjamin Healthcare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 CenterCCN 225654
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jan 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
20580.1 residents per day on average
Penalties (3 years)
1Fines totaling $96,705

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Joseph D Feaster Individual Corporate DirectorReceiver Apr 3, 2024
Operational/Managerial Control Apr 3, 2024
Delicia Mark Individual Corporate OfficerFacilities Administrator May 28, 2024
Operational/Managerial Control May 28, 2024
Kenya Hanspard Individual 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.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

Verify at the official NPI Registry.