1. Home
  2. Directory
  3. Massachusetts
  4. Hyde Park
  5. Nursing Facility Intermediate Care Facility
  6. NPI Profile

FAIRMOUNT REST HOME, INC.
NPI 1306971254
Nursing Facility/Intermediate Care Facility in Hyde Park, MA

Active since February 22, 2007CLIA 22D2123712 · Waiver
172 FAIRMOUNT AVE, 172 FAIRMOUNT AVE, HYDE PARK, MA 02136(617) 361-5150(617) 361-7951 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fairmount Rest Home, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRMOUNT REST HOME, INC. (NPI 1306971254) is a healthcare organization registered as a nursing facility/intermediate care facility in Hyde Park, Massachusetts and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through December 28, 2026 and lists Susan Marden, Owner, as its authorized official.

NPPES Registry Identity

NPI1306971254
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameFAIRMOUNT REST HOME, INC.
Location Address172 FAIRMOUNT AVE, 172 FAIRMOUNT AVEHyde Park, MA 02136-3506
Mailing Address172 Fairmount Ave, 172 Fairmount AveHyde Park, MA 02136-3506 · (617) 361-5150 · Fax (617) 361-7951
Phone(617) 361-5150
Fax(617) 361-7951
Organization SubpartNo
Authorized OfficialSusan MardenOwner · (617) 361-5150
Enumeration DateFebruary 22, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1306971254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in MA · 1387
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
172 FAIRMOUNT AVE, Hyde Park, MA 02136
Open in Google Maps ↗

Other Identifiers 1

Medicaid5505739MA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2123712

Fairmount Rest Home · Hyde Park, MA
Active · expires Dec 28, 2026
CLIA Number22D2123712
Laboratory TypeRest Home
Certificate Effective DateDecember 29, 2024
Certificate Expiration DateDecember 28, 2026
Laboratory DirectorYves M. Lyncee
Laboratory Phone(617) 361-5150
Laboratory LocationFairmount Rest Home172 Fairmount Ave, Hyde Park, MA 02136
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairmount Rest Home, Inc.'s NPI number?

The NPI number for Fairmount Rest Home, Inc. is 1306971254. It was assigned to this organization in the NPPES registry on February 22, 2007.

Where is Fairmount Rest Home, Inc. located?

Fairmount Rest Home, Inc. is located at 172 Fairmount Ave 172 Fairmount Ave, Hyde Park, MA 02136. The listed phone number is (617) 361-5150.

What is Fairmount Rest Home, Inc.'s specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Fairmount Rest Home, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2123712) is associated with this NPI, valid through December 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fairmount Rest Home, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.