NPIMap

Organization Active NPI

Lecom at Village Square, LLC

  • Skilled Nursing Facility
  • Erie, PA
National Provider Identifier
1689231029
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LECOM AT VILLAGE SQUARE, LLC
Practice address
149 W 22ND St
Erie, PA 16502-2804
Phone
(814) 452-3271
NPI assigned
May 21, 2019
Last updated
Oct 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Authorized official

Name
Dr. Jaime Babiak, PHARMD, MHSA
Title
Director of LTC Operations
Phone
(814) 452-3271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

149 W 22ND St
Erie, PA 16502-2804

Mailing address

5535 Peach St
Erie, PA 16509-2603
Phone (814) 452-3271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190725001794 PA Part A Provider - Skilled Nursing Facility 2860728045 Practice locations: Erie, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689231029. Details of each certification follow.

Skilled nursing facility certification: CCN 395672

Legal name
LECOM AT VILLAGE SQUARE LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 16, 1984
Last certification
Nov 19, 2024
Beds
110
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Lecom Health
Organization structure
LLCNon-profit
Incorporated
May 3, 2019 in PA
Enrollment address
149 W 22ND St
Erie, PA 16502-2804
Nursing home name
LECOM AT VILLAGE SQUARE, LLC
Affiliated entity
LECOM SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
LECOM At Village Square, LlcCCN 395672 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 16, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11097.3 residents per day on average
Chain
Lecom Senior Living5 facilities in the chain
Penalties (3 years)
1Fines totaling $10,033

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0183967Lecom at Village Square149 W 22ND St, Erie, PA 16502Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
John M Ferretti Individual Corporate OfficerPresident May 3, 2019
Corporate Director May 3, 2019
Joshua Alan Beerbower Individual Operational/Managerial Control Nov 3, 2023
Adp of the SNF Nov 3, 2023
Millcreek Manor Organization, Erie, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 3, 2019 100%
Luigi G Diianni Individual Corporate Director Mar 18, 2025
Trustee of the SNF Mar 18, 2025
Silvia M Ferretti Individual Corporate Director May 3, 2019
Joseph Kelly Individual Corporate Director Jan 1, 2023
Trustee of the SNF Jan 1, 2023
James Yi Lin Individual Corporate DirectorMedical Director Feb 1, 2016
Joyce Savocchio Individual Corporate Director May 3, 2019
Jaime Lynn Babiak Individual Operational/Managerial ControlDirector of Long Term Care Opera Nov 21, 2022
Adp of the SNF Nov 21, 2022
Millcreek Health System Organization, Erie, PA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest May 3, 2019 100%
Individual Adp of the SNF Jun 28, 2024
Steven Inman Individual Corporate OfficerVice President of Fiscal Affairs May 3, 2019
Esther Fucci Individual Corporate Director May 3, 2019
Individual Adp of the SNF Apr 28, 2025
Mary L Eckert Individual Corporate OfficerSecretary May 3, 2019
Corporate Director May 3, 2019
Individual Adp of the SNF Apr 28, 2025
Vincent S Fierro Individual Corporate Director May 3, 2019

Owners & managing parties with NPI records 5

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

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

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.

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": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1689231029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-452-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 W 22ND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022804",
            "telephone_number": "814-452-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LECOM AT VILLAGE SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "BABIAK",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "DIRECTOR OF LTC OPERATIONS",
        "authorized_official_telephone_number": "814-452-3271",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD, MHSA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.