NPIMap

Organization Active NPI

Millcreek Manor

  • Skilled Nursing Facility
  • Erie, PA
National Provider Identifier
1780688259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
131102 Issued in PA
Legal business name
MILLCREEK MANOR
Practice address
5515 Peach St
Erie, PA 16509-2603
Phone
(814) 868-7395
NPI assigned
Jun 13, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Richard Olinger
Title
Chief Financial Officer
Phone
(814) 868-8167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 131102 PA Primary

Addresses

Primary practice location

5515 Peach St
Erie, PA 16509-2603

Mailing address

5515 Peach St
Erie, PA 16509-2603
Phone (814) 868-7395

Other identifiers 1

IdentifierTypeStateIssuer
0012079290002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080715000810 PA Part A Provider - Skilled Nursing Facility 1456424084 2 other NPIs on this enrollment
Practice locations: Erie, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780688259. Details of each certification follow.

Skilled nursing facility certification: CCN 396072

Legal name
MILLCREEK MANOR
Doing business as
LECOM HEALTH
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 24, 2000
Last certification
Jan 24, 2025
Beds
144
Ownership / control type
Nonprofit Corporation
Multi-facility organization
LECOM
Organization structure
CorporationProprietary
Incorporated
Nov 27, 1989 in PA
Enrollment address
5535 Peach St
Erie, PA 16509-2603
Nursing home name
MILLCREEK MANOR
Affiliated entity
LECOM SENIOR LIVING

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Millcreek ManorCCN 396072 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 24, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
144139.0 residents per day on average
Chain
Lecom Senior Living5 facilities in the chain
Penalties (3 years)
1Fines totaling $100,240

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Millcreek Manor Pharmacy12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Joshua Alan Beerbower Individual Operational/Managerial Control Nov 3, 2023
Adp of the SNF Nov 3, 2023
James Yi Lin Individual Corporate DirectorPresident Jul 1, 2024
Trustee of the SNF Jul 1, 2024
Adp of the SNF Apr 28, 2025
Individual Adp of the SNF Jun 28, 2024
Individual Adp of the SNF Apr 28, 2025
Jaime Lynn Babiak Individual Operational/Managerial Control Nov 21, 2022
Millcreek Health System Organization, Erie, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 8, 2003 100%
Adp of the SNF Nov 8, 2003
Steven Inman Individual Corporate DirectorVP Fiscal Affairs Sep 1, 2023

Owners & managing parties with NPI records 1

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

  • James Y Lin, DO
    • Geriatric Medicine (Internal Medicine) Physician
    • Erie, PA
    • NPI 1164599155

    Adp of the SNF, Corporate Director, Trustee of the SNF

    CMS ownership

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lecom at Village Square LLCErie, PA, CCN 395672 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 3, 2019
Lecom Senior Living CenterErie, PA, CCN 395474 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 3, 2023
Lecom at Snyder MemorialMarienville, PA, CCN 395728 Skilled nursing facility Adp of the SNF Jun 1, 2025
Saint Mary's at Asbury RidgeErie, PA, CCN 396081 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Trustee of the SNF
Adp of the SNF		 May 1, 2025
May 1, 2025
May 1, 2025
Rural Health Clinic of WattsburgErie, PA, CCN 393929 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 24, 2023
Rural Health Clinic of AshtabulaAshtabula, OH, CCN 363882 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 19, 2024
Rural Health Clinic of MeadvilleMeadville, PA, CCN 393930 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1989

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 3

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 2

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780688259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-868-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-868-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLCREEK MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLINGER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "814-868-8167",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "131102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012079290002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.