170 West Avenue Operating Company, LLC
NPI 1245784271ActiveOrganization· Skilled Nursing Facility· Brockport, NY
Skilled Nursing Facility in Brockport, New York, registered in NPPES in August 2016. The authorized official on file is Jeffrey Rubin, Co- Chief Executive Officer. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1245784271 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 8, 2016 |
| 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 Brockport
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