Cameo Nursing Home, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CAMEO NURSING HOME, LLC

Doing business as

Autumn Lake Healthcare at Greenfield

Practice address

5790 S 27TH St
Milwaukee, WI 53221-4129

Phone

(414) 282-1300

NPI assigned

Feb 9, 2018

Last updated

Nov 1, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 2

Addresses

Other names 2

• Autumn Lake Healthcare at Greenfield Doing business as
• Cameo Care Center Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932608577. Details of each certification follow.

• CCN 525504 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525504

Legal name

CAMEO NURSING HOME, LLC

Doing business as

AUTUMN LAKE HEALTHCARE AT GREENFIELD

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 1, 1993

Last certification

Dec 12, 2024

Beds

112

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Nov 1, 2018

Organization structure

LLCProprietary

Incorporated

Jul 25, 2017 in NJ

Enrollment address

5790 S 27TH St
Milwaukee, WI 53221-4129

Nursing home name

AUTUMN LAKE HEALTHCARE AT GREENFIELD

Affiliated entity

AUTUMN LAKE HEALTHCARE

Listed as

Autumn Lake Healthcare at GreenfieldCCN 525504 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11291.1 residents per day on average

Chain

Autumn Lake Healthcare59 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

3Fines totaling $152,619

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Autumn Lake Healthcare at Greenfield2 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.

• Cameo Nursing Home, LLC

  dba Autumn Lake Healthcare at Greenfield

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Milwaukee, WI
  • NPI 1912565771
  NPD tax ID

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 1

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

• Keshni Lata Ramnanan, M.D.

  • Internal Medicine Physician
  • Waukesha, WI
  • NPI 1952541849

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Alok Goyal, M.D.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1487634036

  Nursing home

  Care Compare affiliation
• Stephen C Lamberton, MD

  • Family Medicine Physician
  • Cudahy, WI
  • NPI 1558435123

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1932608577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST STE 220",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5790 S 27TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532214129",
            "telephone_number": "414-282-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMEO NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare at Greenfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cameo Care Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachel A. Cambray, M.D.
• Cameo Assisted Living, LLC (The Suites at Greenfield)
• Cameo Care Center Inc.
• Cameo Court LLC
• Cameo Nursing Home, LLC (Autumn Lake Healthcare at Greenfield)
• Beverley Ann Cameron, RN
• Ingrid Cameron, PA-C
• James Michael Cameron, OTR/L
• Julia Cameron, PHD
• Mary Jo Caminiti, ACSW

• Skilled Nursing Facility in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.