JSSG Healthcare LLC.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1427303N Issued in NY

Legal business name

JSSG HEALTHCARE LLC.

Doing business as

Fiddlers Green Manor

Practice address

168 W Main St
Springville, NY 14141-1016

Phone

(716) 592-4781

NPI assigned

Feb 12, 2014

Last updated

Dec 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Goldstein

Title

Managing Member

Phone

(516) 621-5400

Specialties & licenses 1

Addresses

Other names 1

• Fiddlers Green Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316361298. Details of each certification follow.

• CCN 335457001 Skilled nursing facility · Details

Skilled nursing facility certification: CCN 335457001

Legal name

JSSG HEALTHCARE LLC

Doing business as

FIDDLERS GREEN MANOR REHABILITATION AND NURSING CENTER

Organization structure

LLCProprietary

Incorporated

Sep 1, 2011 in NY

Enrollment address

168 W Main St
Springville, NY 14141-1016

Nursing home name

FIDDLERS GREEN MANOR REHAB AND NURSING CENTER

Affiliated entity

THE SHERMAN FAMILY

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hongbiao Liu, MD, PH.D.

  • Hospitalist Physician
  • Niagara Falls, NY
  • NPI 1306160544
  NPD (past)

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418774400000",
    "number": "1316361298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 W MAIN ST",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "141411016",
            "telephone_number": "716-592-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 W MAIN ST",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "141411016",
            "telephone_number": "716-592-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSSG HEALTHCARE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2014-12-17",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "516-621-5400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "1427303N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fiddlers Green Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Thomas Hurley III, M.D.
• Imaging Services of Western New York PC
• Susan Jackson, SLP
• Jane D. Kraft, MD, PLLC
• Jennie B. Richmond Chaffee Nursing Home Company
• Jessica Judware
• Juniper Radiology, PC
• Alicia Kaufman, LMSW
• Nicole Kaus
• Sherilyn Kehr

• Skilled Nursing Facility in Springville, NY
• Providers in Springville, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; 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.