LAKESIDE BEIKIRCH CARE CENTER, INC. (NPI# 1891791927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891791927 |
| Entity Type | Organization |
| Organization Name | LAKESIDE BEIKIRCH CARE CENTER, INC. |
| Practice Address |
170 West Ave Brockport NY 14420-1227 |
| Practice Telephone | 5853956052 |
| Practice Fax Number | 5853956007 |
| Mailing Telephone | 5853956052 |
| Mailing Fax Number | 5853956007 |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2015-09-03 |
| Authorized Official Name | KIMBERLY KLINETOB (ADMINISTRATOR) |
| Authorized Official Telephone | 5853956095 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
2752301N | NY | Ambulatory Health Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 2752301N | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | PREFERRED CARE | 106288CI | 01 |
| NY | EXCELLUS | CN | 01 |
| NY | 01137113 | 05 |
| Street Address |
170 WEST AVE |
| City | BROCKPORT |
| State | NY |
| Zip Code | 14420-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275045791 | Josiah James Surbatovich | Physician Assistant | 170 West Ave, Brockport, NY 14420-1227 | 2017-10-25 |
| 1245784271 | 170 West Avenue Operating Company, LLC | Skilled Nursing Facility | 170 West Ave, Brockport, NY 14420-1227 | 2016-08-08 |
| 1598830044 | William Michael Covell | Physical Therapist | 170 West Ave, Brockport, NY 14420-1227 | 2006-11-21 |
| 1235221458 | Karyn Felice | Nurse Practitioner | 170 West Ave, Brockport, NY 14420-1227 | 2006-09-28 |
| 1306868633 | Raj Mehta | Internal Medicine | 170 West Ave, Brockport, NY 14420-1227 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194217471 | Brianna Lynn Bunch | Licensed Practical Nurse | 126 White Road, Brockport, NY 14420 | 2018-06-03 |
| 1174012785 | Penny Bowers | Massage Therapist | 27 Market Street, Upstairs, Brockport, NY 14420 | 2018-05-09 |
| 1386172062 | Allison Manly | Dentist | 1000 Transit Way, Brockport, NY 14420 | 2017-05-25 |
| 1235518143 | Erin B Chapman | Physical Medicine & Rehabilitation | 350 New Campus Drive, Brockport, NY 14420 | 2015-05-26 |
| 1972853653 | Theresa Fox Lehman | Specialist | 32 Mission Hill Drive, Brockport, NY 14420 | 2012-09-11 |
| 1689946303 | Beverly Whiteman | Registered Nurse | 40 Allen St., Brockport, NY 14420 | 2012-01-27 |
| 1316217425 | Julie Ann Knapp | Registered Nurse | 40 Allen Street, Brockport Central School District, Brockport, NY 14420 | 2012-01-05 |
| 1851678965 | Jennifer Anne Cohen | Registered Nurse | 188 Utica Street, Brockport, NY 14420 | 2011-11-03 |
| 1205088960 | Amy Maureen Hennessy | Obstetrics & Gynecology | 6668 Fourth Section Rd Ste 500, Brockport, NY 14420 | 2008-10-14 |
| 1053454884 | Nancy S Iafrati | Nurse Practitioner | Suny Brockport Student Health Center, 350 New Campus Drive, Brockport, NY 14420 | 2007-02-14 |
| Find all providers in zip 14420 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245784271 | 170 West Avenue Operating Company, LLC | Skilled Nursing Facility | 170 West Ave, Brockport, NY 14420-1227 | 2016-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730701343 | Diamond Medical Employment Agency Inc | Skilled Nursing Facility | 21873 Hempstead Ave, Queens Village, NY 11429-2103 | 2020-05-18 |
| 1427670884 | Morris Park Rehabilitation and Nursing Center LLC | Skilled Nursing Facility | 1235 Pelham Parkway North, Bronx, NY 10469 | 2020-05-08 |
| 1659936334 | Nelson Tannis | Skilled Nursing Facility | 165 Broadway, New York, NY 10006-1404 | 2019-05-07 |
| 1295390029 | Westgate Operations Associates LLC | Skilled Nursing Facility | 525 Beahan Rd, Rochester, NY 14624-3403 | 2019-05-07 |
| 1952883423 | Roscoe Regional Healthcare LLC | Skilled Nursing Facility | 420 Rockland Rd, Roscoe, NY 12776-6450 | 2018-08-31 |
| 1164904769 | Renaissance Healthcare Group, LLC | Skilled Nursing Facility | 4975 Albany Post Rd, Staatsburg, NY 12580-6032 | 2018-08-30 |
| 1477049807 | Itkin Occupational Therapy PC | Skilled Nursing Facility | 134 Mackenzie Street, Brooklyn, NY 11235 | 2018-07-09 |
| 1699280826 | 239 Legris Avenue Operations LLC | Skilled Nursing Facility | 3118 Quentin Rd, Brooklyn, NY 11234-4235 | 2017-12-11 |
| 1376058578 | Yonkers Gardens, LLC | Skilled Nursing Facility | 115 S Broadway, Yonkers, NY 10701-4006 | 2017-12-10 |
| 1104355536 | Massapequa Center LLC | Skilled Nursing Facility | 101 Louden Ave., Amityville, NY 11701 | 2017-06-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LAKESIDE BEIKIRCH CARE CENTER, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.