Laconia Nursing Home Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

7000370N Issued in NY

Legal business name

LACONIA NURSING HOME INC.

Practice address

1050 E 230TH St
Bronx, NY 10466-4810

Phone

(718) 654-5875

Fax

(718) 701-5684

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Luba Servil

Title

Office Manager

Phone

(718) 654-5875

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335388

Legal name

LACONIA NURSING HOME INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 15, 1973

Last certification

Jan 23, 2024

Beds

240

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Enrollment address

1050E 230TH St
Bronx, NY 10466-4810

Nursing home name

LACONIA NURSING HOME

Listed as

Laconia Nursing HomeCCN 335388 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Nov 15, 1973

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

240234.6 residents per day on average

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

Tax ID family

Laconia Nursing Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stonehedge Aquisition Chittenango I, LLC

  • Skilled Nursing Facility
  • Chittenango, NY
  • NPI 1477541084
  NPD tax ID

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

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

• Vijay Khatiwala, M.D.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1831160589

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Practitioners 3

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

• Vijay Khatiwala, M.D.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1831160589
  NPD (past)
• Allan R Santiago, MD

  • Infectious Disease Physician
  • Brooklyn, NY
  • NPI 1235106527
  NPD (past)
• Leslie Walter, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1912001249
  NPD (past)

Affiliated clinicians 4

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

• Vijay Khatiwala, M.D.

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1831160589

  Nursing home

  Care Compare affiliation
• Allan R Santiago, MD

  • Infectious Disease Physician
  • Brooklyn, NY
  • NPI 1235106527

  Nursing home

  Care Compare affiliation
• Leslie Walter, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1912001249

  Nursing home

  Care Compare affiliation
• Ali Tabarroki, M.D.

  • Family Medicine Physician
  • Paramus, NJ
  • NPI 1952794489

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1457435877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E 230TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104664810",
            "telephone_number": "718-654-5875",
            "fax_number": "718-405-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E 230TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104664810",
            "telephone_number": "718-654-5875",
            "fax_number": "718-701-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACONIA NURSING HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "SERVIL",
        "authorized_official_first_name": "LUBA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-654-5875",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "7000370N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00311468",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Herbert M Lachman, MD
• Gayann Lackansingh, RN
• Vontrise Lacks, LMSW
• Jonathan Lacmanen
• Laconia Avenue Pharmacy Corp
• Laconia Nursing Homes
• Edward Alexander Lacorte, O.D.
• Amy Uemura Lacount, MD
• Francois Lacour-Gayet, MD
• Nijah Lacourt

• Skilled Nursing Facility in Bronx, NY
• Providers in Bronx, 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 Oct 25, 2011; 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.