Iroquois Nursing Home Inc
Organization Active NPI Skilled Nursing Facility · Jamesville, NY
NPI 1013926526 · NPPES record last updated May 20, 2022
Key facts
- NPI
- 1013926526
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 3353300N (NY)
- Legal business name
- IROQUOIS NURSING HOME INC
- Practice address
- 4600 Southwood Heights Dr
Jamesville, NY 13078-9595 - Phone
- (315) 469-1300
- Fax
- (315) 469-5545
- NPI assigned
- Aug 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Maggie Calli
- Title
- President
- Phone
- (315) 469-1300
Owners & managing parties with NPI records 1
-
Mitchell Lebowitz, M.D.
Owned or controlled facilities with NPI records 1
Practitioners 5
-
Musan Durakovic, N.P.
-
Aji Kurian, PA
-
Sandy Charles Van Every, PA-C
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Iroquois Nursing Home Inc
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Nov 4, 1992
- Medicare certification status
- Active
- Certified beds
- 160 · 156.8 residents per day on average
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D0861072 | Iroquois Nursing Home Inc | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
Skilled nursing facility certification: CCN 335764
- Legal name
- IROQUOIS NURSING HOME, INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 4, 1992
- Last certification
- Aug 20, 2024
- Beds
- 160
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 17, 1990 in NY
- Enrollment address
- 4600 Southwood Heights Dr
Jamesville, NY 13078-9595 - Nursing home name
- IROQUOIS NURSING HOME INC
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Mark Murphy |
Corporate Director | Jan 1, 2013 | |
| Sarah Bonner |
W-2 Managing Employee | Apr 16, 2012 | |
| John Bergemann |
Corporate Director | Jan 1, 2009 | |
| Kelli Harris |
Corporate Director | Jan 1, 2014 | |
| Barbara Drapola |
Corporate Director | Jan 1, 2013 | |
| Sonya Moshier |
Corporate Director | Mar 17, 2008 | |
| Melissa a Allard |
Corporate Director | Jan 1, 2015 | |
| Steve Infanti |
Corporate Director | Jan 1, 2016 | |
| Anita Anderson |
Corporate Director | Jan 1, 2004 | |
| Mickey R Lebowitz |
Corporate Director | Jan 1, 2012 | |
| Penny L Hefferon |
Corporate Officer | Jan 1, 2012 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| The Cottages at Garden Grove |
Skilled nursing facility | Adp of the SNF | Sep 3, 2014 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040823001207 | NY | Part B Supplier - Clinic/Group Practice | 4587638804 |
Receives reassigned benefits from 5 practitioners Practice locations: Jamesville, NY |
| O20080410000106 | NY | Part a Provider - Skilled Nursing Facility | 4587638804 | Practice locations: Jamesville, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3353300N | NY | Yes |
Addresses
Primary practice location
4600 Southwood Heights Dr
Jamesville, NY 13078-9595
Mailing address
4600 Southwood Heights Dr
Jamesville, NY 13078-9595
Phone (315) 469-1300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01370305 | Medicaid | NY |
Other providers in Jamesville, NY
- Cheryl L Hoosock
- Paris B Horan
- Beth W Hudson
- Judith A Hughes
- Integrated Medicine of Syracuse
- Jamesville Family Medicine and Wellness PC
- Cathy Jaworski
- Rangachar Keshava Prasad
- Kristin Marie Kim
- Susi Koshy
All providers in Jamesville, NY · Skilled Nursing Facility in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.