Park Waverly Healthcare LLC
NPI 1629079975 · Skilled Nursing Facility · Tucson, AZ
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Park Waverly Healthcare LLC is a Skilled Nursing Facility organization in Tucson, AZ (NPI 1629079975).
Provider details
- NPI number
- 1629079975
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Soon Burnam, Authorized Agent(949) 540-1249
- License
- NCI-2639 (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Park Avenue Health and Rehabilitaion Center
- Doing business as
- Park Avenue Health and Rehabilitaion Center
Registry dates
- Enumerated
- 2005-08-09
- Last updated
- 2021-02-16
- Certified
- 2021-02-16
Frequently asked questions
- What is Park Waverly Healthcare LLC's NPI number?
- Park Waverly Healthcare LLC's National Provider Identifier (NPI) is 1629079975, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Park Waverly Healthcare LLC?
- Park Waverly Healthcare LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Park Waverly Healthcare LLC located?
- Park Waverly Healthcare LLC's practice location on file with NPPES is 2001 North Park Avenue, Tucson, AZ 85719-3558.
- What is Park Waverly Healthcare LLC's phone number?
- The practice phone number listed in the NPPES registry for Park Waverly Healthcare LLC is (520) 882-6151.
- Does Park Waverly Healthcare LLC accept Medicare?
- Park Waverly Healthcare LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Park Waverly Healthcare LLC?
- The authorized official listed on Park Waverly Healthcare LLC's NPPES record is Soon Burnam, Authorized Agent. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Park Waverly Healthcare LLC's NPI active?
- Yes — Park Waverly Healthcare LLC's NPI (1629079975) is active in the NPPES registry as of the last update on 2021-02-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.