4459 Bailey Avenue Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

4459 BAILEY AVENUE OPERATING COMPANY LLC

Doing business as

Elderwood at Amherst

Practice address

4459 Bailey Ave
Amherst, NY 14226-2129

Phone

(716) 835-2543

NPI assigned

Feb 10, 2012

Last updated

Jan 19, 2023By 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

Dr. Jeffrey Rubin

Title

Co-Chief Executive Officer

Phone

(716) 817-5075

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elderwood at Amherst 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 1467725101. Details of each certification follow.

• CCN 335056 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 335056

Legal name

4459 BAILEY AVENUE OPERATING COMPANY LLC

Doing business as

ELDERWOOD AT AMHERST

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 9, 1967

Last certification

Apr 18, 2025

Beds

92

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Elderwood

Organization structure

LLCProprietary

Incorporated

Oct 12, 2011 in NY

Enrollment address

4459 Bailey Ave
Amherst, NY 14226-2129

Nursing home name

ELDERWOOD AT AMHERST

Affiliated entity

ELDERWOOD

Listed as

Elderwood at AmherstCCN 335056 · 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 - Limited Liability company

Certified

Jan 9, 1967

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9281.1 residents per day on average

Chain

Elderwood17 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $25,262

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 2

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.

• Richard Andrew Carlson Jr, MD

  • Internal Medicine Physician
  • Tonawanda, NY
  • NPI 1740246735
  NPD (past)
• Michael Henry Kueker, MD

  • Family Medicine Physician
  • Buffalo, NY
  • NPI 1013414986
  NPD (past)

Affiliated clinicians 2

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

• Richard Andrew Carlson Jr, MD

  • Internal Medicine Physician
  • Tonawanda, NY
  • NPI 1740246735

  Nursing home

  Care Compare affiliation
• Michael Henry Kueker, MD

  • Family Medicine Physician
  • Buffalo, NY
  • NPI 1013414986

  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": "1467725101",
    "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": "4459 BAILEY AVE",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262129",
            "telephone_number": "716-835-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4459 BAILEY AVENUE 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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elderwood at Amherst",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elderwood at Amherst",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 4-Kids Optical
• Michelle Ababurko, LMT
• Pamela Joy D Abantao, PT
• Andrea Abbate, BSW, M.S.ED
• Amanda Abbey
• Younes A Abdulla, NP

• Skilled Nursing Facility in Amherst, NY
• Providers in Amherst, 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 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.