200 Bassett Road Operating Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

200 BASSETT ROAD OPERATING COMPANY LLC

Doing business as

Elderwood at Williamsville

Practice address

200 Bassett Rd
Williamsville, NY 14221-2639

Phone

(716) 689-6681

NPI assigned

Feb 12, 2012

Organization subpart

No

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

Authorized official

Name

Rebecca Golub

Title

Paralegal

Phone

(917) 683-0267

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elderwood at Williamsville Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Skilled nursing facility certification: CCN 335326001

Legal name

200 BASSETT ROAD OPERATING COMPANY, LLC

Doing business as

ELDERWOOD AT WILLIAMSVILLE

Organization structure

LLCProprietary

Incorporated

Oct 12, 2011 in NY

Enrollment address

200 Bassett Rd
Williamsville, NY 14221-2639

Nursing home name

ELDERWOOD AT WILLIAMSVILLE

Affiliated entity

ELDERWOOD

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

200 Bassett Road Operating Company LLC2 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.

• 200 Bassett Road Operating Company, LLC

  • Long Term Care Pharmacy
  • Williamsville, NY
  • NPI 1407281835
  NPD tax ID

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 4

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

• Michael Henry Kueker, MD

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

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1265404982
  NPD (past)
• Charles W Yates, MD

  • Family Medicine Physician
  • Cheektowaga, NY
  • NPI 1134112691
  NPD (past)
• Romain Calini

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1285175687
  NPD (past)

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

{
    "created_epoch": "1329004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1467725168",
    "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": "200 BASSETT RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212639",
            "telephone_number": "716-689-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "200 BASSETT ROAD OPERATING COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-12",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "GOLUB",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PARALEGAL",
        "authorized_official_telephone_number": "917-683-0267"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1287874",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elderwood at Williamsville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elderwood at Williamsville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 200 Bassett Road Operating Company, LLC
• 200 West Optics, LLC
• A.W. Jones MD PC
• Lacie Abbey, LPN
• Salah Abdelhadi, M.D.

• Skilled Nursing Facility in Williamsville, NY
• Providers in Williamsville, 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 17, 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.