PARK AVENUE HEALTH AND REHABILITAION CENTER
NPI 1629079975
Skilled Nursing Facility in Tucson, AZ


Overall Rating: 2 out of 5 stars

NPI Status: Active since August 09, 2005

Contact Information

2001 NORTH PARK AVENUE
TUCSON, AZ
ZIP 85719
Phone: (520) 882-6151
Fax: (520) 620-1547

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  • Organization
  • Skilled Nursing Facility
  • Accepts Insurance
  • CLIA Number: 03D0700498
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About PARK AVENUE HEALTH AND REHABILITAION CENTER

This page provides the complete NPI Profile along with additional information for Park Avenue Health And Rehabilitaion Center, a provider established in Tucson, Arizona operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1629079975 assigned on August 2005. The practitioner's primary taxonomy code is 314000000X with license number NCI-2639 (AZ). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Park Avenue Health And Rehabilitaion Center. The authorized official of this NPI record is Ms. Soon Burnam (Authorized Agent)

NPI
1629079975
Provider Legal Name
PARK WAVERLY HEALTHCARE LLC
Other Organization Name
PARK AVENUE HEALTH AND REHABILITAION CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2001 NORTH PARK AVENUE TUCSON, AZ 85719
Location Phone
(520) 882-6151
Location Fax
(520) 620-1547
Mailing Address
2001 NORTH PARK AVENUE TUCSON, AZ 85719
Mailing Phone
(520) 882-6151
Mailing Fax
(520) 620-1547
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-09-2005
Last Update Date
02-16-2021
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According to the Nursing Home Compare program data, Park Avenue Health And Rehabilitaion Center has a below average overall quality rating based on the provider's performance on three separate measures including: health inspections, staffing, and quality of resident care information. These quality measures, combined in a star rating of 2 out of 5 stars provide a snapshot of this nursing home quality.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
NCI-2639
License State
AZ
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • AZ Blue ACA StandardHealth Silver with Health Choice - HMO
  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
  • AZ Blue Portfolio Bronze HSA Focus - HMO
  • AZ Blue StandardHealth Bronze Focus - HMO
  • AZ Blue StandardHealth Gold Focus - HMO
  • AZ Blue StandardHealth Silver Focus - HMO
  • Imperial Preferred Gold - HMO
  • Imperial Preferred Silver - HMO
  • Imperial Standard Bronze - HMO
  • Imperial Standard Gold - HMO
  • Imperial Standard Silver - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Standard - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Silver Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. SOON BURNAM

Authorized Official Title
AUTHORIZED AGENT
Authorized Official Phone
(949) 540-1249

Nursing Home Quality Information

The Centers for Medicare and Medicaid Services publishes the Nursing Home Compare star rating data to provide consumers an easy way to compare nursing home's quality of care.

Overall Quality Rating - 2 out of 5 stars - Below Average
The overall star rating is based on a nursing homes's performance on health inspections, staffing and quality measures.
Health Inspection RatingNot Available
The health inspection star rating is based on a nursing home’s weighted score from the most recent health inspections.
Quality Measures Rating - 5 out of 5 stars - Much Above Average
The quality measures star rating is based on data from a select set of clinical measures.
Long-Stay Quality Measures Rating - 5 out of 5 stars - Much Above Average
The long-stay quality of care rating is based on the quality of care delivered to long-term residents only.
Short-Stay Quality Measures Rating - 4 out of 5 stars - Above Average
The short-stay quality of care rating is based on the quality of care delivered to temporary residents only.
Staffing Rating - 3 out of 5 stars - Average
The staffing rating is based on the star rating based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practice Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Nurse aides.
Nurse Aide Staffing Hours2.03 hours per resident per day
Nurse aide hours per resident per day. Higher number of hours are better.
RN Staffing Hours0.38 hours per resident per day
Resgistered nurse hours per resident per day. Higher number of hours are better.
RN Staff Turnover50%
Resgistered nurse turnover is the percentage of registered nursing staff who stop working at the facility within a given year.
Ownership TypeFor profit - Corporation
Is the facility private for profit, not-for profit or publicly owned.
Number of Certified Beds200 beds
Number of beds in the nursing home that have been approved by the federal government to participate in the Medicare or Medicaid programs.
Residents per Day118 residents
Average number of residents living in the facility per day.
Automatic Sprinkler SystemsYes
Does the facility have automatic sprinkler systems in all required areas?
Facility Reported Incidents4 incidents
Number of facility-reported incidents in the past 3 years. A lower number is better.
Substantiated Complaints8 complaints
Number of substantiated complaints in the past 3 years. A lower number is better.
Citations from Inspections1 citations after infection control inspection
Number of citations from infection control inspections in the past 3 years. A lower number is better.
Total Number of Penalties0 penalties from a serious health, fire safety or long-term unresolved citation
The Medicare program may impose penalties on a facilty when there's serious health or fire safety citations or if the facility fails to correct a citation for a long period of time.
Number of Fines0 fines
Toal number of fines in the last 3 years. A penalty can be a fine against the facility or denied payments from Medicare.
Amount of Fines$0.00
Total monetary amount of fine imposed on the facility in the last 3 years.

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D0700498
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
MICHAEL KEDANSKY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Park Avenue Health And Rehabilitaion Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629079975, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
0
Doubled → 0
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 9 → 18 → 9 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 0 + 7 + 1 + 8 + 9 + 1 + 4 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1629079975.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629079975, enumerated as an "organization" on August 09, 2005.

The provider is located at 2001 NORTH PARK AVENUE TUCSON, AZ 85719 and the phone number is (520) 882-6151.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Antidote. Please consult your insurance carrier or call the provider to verify.