112 Ski Bowl Road Operating Company, LLC
NPI 1205345501ActiveOrganization· Skilled Nursing Facility· North Creek, NY
Skilled Nursing Facility in North Creek, New York, registered in NPPES in September 2017. The authorized official on file is Jeffrey Rubin, Co-Chief Executive Officer. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1205345501 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 29, 2017 |
| Last updated in NPPES | Jan 19, 2023 |
| Certified by provider | Jan 19, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (NY) |
|---|
Other Skilled Nursing Facility providers in North Creek
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