37 North Chemung Street Operating Company LLC
Organization Active NPI Skilled Nursing Facility · Waverly, NY
NPI 1891068565 · NPPES record last updated Jan 19, 2023
Key facts
- NPI
- 1891068565
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 37 NORTH CHEMUNG STREET OPERATING COMPANY LLC
- Practice address
- 37 N Chemung St
Waverly, NY 14892-1211 - Phone
- (607) 565-6329
- NPI assigned
- Feb 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey Rubin
- Title
- Co-Chief Executive Officer
- Phone
- (716) 817-5075
Corporate family (same tax ID) 1
Practitioners 3
-
Dara Grieger, MD
-
Joseph Mwesige, M.D
Affiliated clinicians 3
-
Dara Grieger, MD
-
Joseph Mwesige, M.D
Medicare Care Compare: Nursing home
- Listed as
- Elderwood at Waverly
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Dec 10, 1971
- Medicare certification status
- Active
- Certified beds
- 200 · 178.9 residents per day on average
- Chain
- Elderwood
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 2 · fines totaling $120,884
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Skilled nursing facility certification: CCN 335346
- Legal name
- 37 NORTH CHEMUNG STREET OPERATING COMPANY, LLC
- Doing business as
- ELDERWOOD AT WAVERLY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 10, 1971
- Last certification
- Mar 28, 2025
- Beds
- 200
- Ownership / control type
- Individual
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 12, 2011 in NY
- Enrollment address
- 37N Chemung St
Waverly, NY 14892-1211 - Nursing home name
- ELDERWOOD AT WAVERLY
- Affiliated entity
- ELDERWOOD
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Rubin |
5% Or Greater Direct Ownership Interest | Oct 14, 2011 | 50% |
| Operational/Managerial Control |
Oct 14, 2011 | 50% | |
| Maria Landy |
W-2 Managing Employee |
Jan 31, 2013 | 100% |
| Warren D Cole |
5% Or Greater Direct Ownership Interest | Oct 14, 2011 | 50% |
| Operational/Managerial Control |
Oct 14, 2011 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121121000050 | NY | Part a Provider - Skilled Nursing Facility | 1153572177 | Practice locations: Waverly, NY |
National Provider Directory
- Tax ID family
- 37 North Chemung Street Operating Company LLC
Locations
37 N Chemung St
Waverly, NY 14892
Phone (607) 565-2861
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
37 N Chemung St
Waverly, NY 14892-1211
Mailing address
500 Seneca St Ste 100
Buffalo, NY 14204-1963
Phone (716) 633-3900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00362689 | Medicaid | NY |
Other names
- Elderwood at Waverly
Other providers in Waverly, NY
- 37 North Chemung Street Operating Company, LLC
- 44 Ball Street Operating Company LLC
- Emily Kramer Abbinanti
- Stephanie Corin Ayers
- Wendy Bellis
All providers in Waverly, NY · Skilled Nursing Facility in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.