2850 Grand Island Boulevard Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

2850 GRAND ISLAND BOULEVARD OPERATING COMPANY LLC

Practice address

2850 Grand Island Blvd
Grand Island, NY 14072-1251

Phone

(716) 773-5900

NPI assigned

Feb 10, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Rubin

Title

Co-Chief Executive Officer

Phone

(716) 817-5075

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elderwood at Grand Island Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335391

Legal name

2850 GRAND ISLAND BOULEVARD OPERATING COMPANY LLC

Doing business as

ELDERWOOD AT GRAND ISLAND

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1973

Last certification

Dec 6, 2024

Beds

90

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Post Acute Partners

Organization structure

LLCProprietary

Incorporated

Oct 12, 2011 in NY

Enrollment address

2850 Grand Island Blvd
Grand Island, NY 14072-1251

Nursing home name

ELDERWOOD AT GRAND ISLAND

Affiliated entity

ELDERWOOD

Listed as

Elderwood at Grand IslandCCN 335391

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 1, 1973

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9081.9 residents per day on average

Chain

Elderwood17 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan James Mikac, D.O.

  • Family Medicine Physician
  • Amherst, NY
  • NPI 1346502689
  NPD (past)
• Christopher Schaeffer, MD

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1265404982
  NPD (past)
• Shane Setlock

  • Physical Therapist
  • East Amherst, NY
  • NPI 1730808585
  NPD (past)
• Ranjit Singh, MD

  • Family Medicine Physician
  • Buffalo, NY
  • NPI 1194718486
  NPD (past)
• Paul Eugene Shields, DO

  • Family Medicine Physician
  • Erie, PA
  • NPI 1508861949
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ryan James Mikac, D.O.

  • Family Medicine Physician
  • Amherst, NY
  • NPI 1346502689

  Nursing home

  Care Compare affiliation
• Christopher Schaeffer, MD

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1265404982

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1013280759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SENECA ST STE 100",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142041963",
            "telephone_number": "716-633-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 GRAND ISLAND BLVD",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140721251",
            "telephone_number": "716-773-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2850 GRAND ISLAND BOULEVARD OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CO-CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "716-817-5075",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01148136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elderwood at Grand Island",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elderwood at Grand Island",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohammad H Abdellatif
• Linda C Aidala, PHD
• Brandy Alaimo
• Bonnie V Albrecht, RPT
• Marcia Ann Andolina, M.S. ED. CCC/SLP

• All providers in Grand Island, NY
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.