Meadowbrook Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MEADOWBROOK OPERATING LLC

Practice address

154 Prospect Ave
Plattsburgh, NY 12901-1302

Phone

(518) 563-5440

NPI assigned

Jun 19, 2025

Organization subpart

No

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

Authorized official

Name

Shlomo Boehm

Title

Member

Phone

(718) 360-8083

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Meadowbrook Healthcare Doing business as

Locations

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1629965918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 BAYVIEW AVE",
            "city": "INWOOD",
            "state": "NY",
            "postal_code": "110961702",
            "telephone_number": "718-360-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 PROSPECT AVE",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011302",
            "telephone_number": "518-563-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWBROOK OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-360-8083"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02994732",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowbrook Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin McMaster, MD
• Shannon A McMeekin-Hagadorn, RPAC
• Wanda McQueen, PH.D.
• Maureen McShane, M.D.
• Timothy M McSweeney, D.M.D.
• Nihit Navroz Mehta, DO
• Sally A Meisenheimer
• Molly E. Mentzer, DO
• Karen Merrill
• John Lee Meyer, PHARMACIST

• Skilled Nursing Facility in Plattsburgh, NY
• Providers in Plattsburgh, 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 Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.