34 WILDWOOD AVE OPCO LLC
NPI 1750168704
Skilled Nursing Facility in Madison, CT

Active since September 13, 2023CLIA 07D0888513 · Waiver
1/5
Overall Rating
34 WILDWOOD AVE, MADISON, CT 06443(732) 358-6883 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 34 Wildwood Ave Opco Llc NPPES

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

34 WILDWOOD AVE OPCO LLC (NPI 1750168704), doing business as Autumn Lake Healthcare At Madison, is a healthcare organization registered as a skilled nursing facility in Madison, Connecticut and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through July 7, 2028 and lists Sam Stern, Cfo, as its authorized official.

NPPES Registry Identity

NPI1750168704
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name34 WILDWOOD AVE OPCO LLC
Location Address34 WILDWOOD AVEMadison, CT 06443-2102
Mailing Address14c 53rd StBrooklyn, NY 11232-2644 · (877) 567-0402
Organization SubpartNo
Authorized OfficialSam SternCfo · (877) 567-0402
Enumeration DateSeptember 13, 2023
NPPES CertifiedSeptember 13, 2023
NPI 1750168704 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X
Also ListedRespite CareTaxonomy 385H00000X
34 WILDWOOD AVE, Madison, CT 06443

Other Names 1

Doing Business AsAutumn Lake Healthcare At Madison

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 07D0888513

34 Wildwood Ave Opco LLC Autumn Lake Healthcare At Madison · Madison, CT
Active · expires Jul 7, 2028
CLIA Number07D0888513
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 8, 2026
Certificate Expiration DateJuly 7, 2028
Laboratory DirectorJoseph Balsamo
Laboratory Phone(203) 245-8008
Laboratory Location34 Wildwood Ave Opco LLC Autumn Lake Healthcare At Madison34 Wildwood Ave, Madison, CT 06443
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Autumn Lake Healthcare At Madison (CMS certification number 075405), from CMS Care Compare.

Autumn Lake Healthcare At Madison

Nursing home · Madison, CT
1/5 CMS Overall Rating
OwnershipFor profit - Partnership
CMS Certification Number075405
Certified Beds90 beds84 residents per day on average
Medicare & Medicaid Participant SinceJune 16, 1994
Resident & Family CouncilResident council
Automatic sprinkler system Ownership changed in last 12 months

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
3/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
4/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
132
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.03 · LPN 0.96 · RN 0.51
3.49 hrs per resident per day
Weekend Nurse Staffing
3.33 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
40.3%
Registered Nurse Turnover
66.7%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
5
Substantiated Complaints
7
Fines
3 totaling $33,243.60
Medicare Payment Denials
0
Total Penalties
3
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Adult Health)
34 WILDWOOD AVE
MADISON, CT 06443
Speech-Language Pathologist
34 WILDWOOD AVE
MADISON, CT 06443
Nurse Practitioner (Family)
34 WILDWOOD AVE
MADISON, CT 06443
Speech-Language Pathologist
34 WILDWOOD AVE
MADISON, CT 06443
Occupational Therapy Assistant
34 WILDWOOD AVE
MADISON, CT 06443
Skilled Nursing Facility
34 WILDWOOD AVE
MADISON, CT 06443
Speech-Language Pathologist
34 WILDWOOD AVE
MADISON, CT 06443
Nurse Practitioner (Family)
34 WILDWOOD AVE
MADISON, CT 06443

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 34 Wildwood Ave Opco LLC's NPI number?

The NPI number for 34 Wildwood Ave Opco LLC is 1750168704. It was assigned to this organization in the NPPES registry on September 13, 2023. The provider is doing business as Autumn Lake Healthcare at Madison.

Where is 34 Wildwood Ave Opco LLC located?

34 Wildwood Ave Opco LLC is located at 34 Wildwood Ave, Madison, CT 06443. The listed phone number is (732) 358-6883.

What is 34 Wildwood Ave Opco LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does 34 Wildwood Ave Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D0888513) is associated with this NPI, valid through July 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is 34 Wildwood Ave Opco LLC a Medicare-certified nursing home?

Yes. Autumn Lake Healthcare At Madison is a Medicare-certified nursing home with 90 certified beds.

What quality rating does 34 Wildwood Ave Opco LLC have?

CMS rates Autumn Lake Healthcare At Madison 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for 34 Wildwood Ave Opco LLC was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.