NPIMap

Organization Active NPI

Lakeview Healthcare Operating LLC

  • Skilled Nursing Facility
  • Smethport, PA
National Provider Identifier
1386381101
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKEVIEW HEALTHCARE OPERATING LLC
Doing business as
Lakeview Healthcare & Rehab
Practice address
15 W Willow St
Smethport, PA 16749-1523
Phone
(814) 887-5716
NPI assigned
May 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Mike Zidele
Title
Member
Phone
(716) 374-2526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

15 W Willow St
Smethport, PA 16749-1523

Mailing address

15 W Willow St # a
Smethport, PA 16749-1523

Other names 1

  • Lakeview Healthcare & Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220721000679 PA Part A Provider - Skilled Nursing Facility 0143601260 Practice locations: Smethport, PA

Skilled nursing facility certification: CCN 395867

Legal name
LAKEVIEW HEALTHCARE OPERATING LLC
Doing business as
LAKEVIEW HEALTHCARE AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 30, 1991
Last certification
May 30, 2025
Beds
34
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Bonamour Healthcare Group LLC
Organization structure
LLCProprietary
Incorporated
May 13, 2022 in DE
Enrollment address
15 W Willow Street
Smethport, PA 16749-1523
Nursing home name
AMARYLLIS NURSING AND REHAB
Affiliated entity
BONAMOUR HEALTH GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Amaryllis Nursing and RehabCCN 395867 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 30, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3432.3 residents per day on average
Chain
Bonamour Health Group5 facilities in the chain
Penalties (3 years)
2Fines totaling $6,631

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

15 W Willow St
#A
Smethport, PA 16749

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Yeshayahu Zidele Individual 5% Or Greater Direct Ownership Interest Jun 28, 2022 50%
Adp of the SNF Jun 28, 2022
Indirect Ownership Interest Jun 28, 2022 50%
Bonamour Health Group LLC Organization, Smethport, PA LLC, For-profit Operational/Managerial Control Jun 28, 2022 100%
Adp of the SNF Mar 3, 2025
Patricia Barber Individual Operational/Managerial Control Jul 31, 2023
Adp of the SNF Jul 31, 2023
Brandon M Roscoe Individual Adp of the SNF Jun 28, 2022
Mordechai Zidele Individual 5% Or Greater Direct Ownership Interest Jun 28, 2022 50%
Adp of the SNF Jun 28, 2022
Direct Ownership Interest Jun 28, 2022 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1386381101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W WILLOW ST # A",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W WILLOW ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491523",
            "telephone_number": "814-887-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW HEALTHCARE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "ZIDELE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "716-374-2526"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Healthcare & Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeview Healthcare & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smethport, PA

Sources for this page

Verify at the official NPI Registry.