1019 Wicker Street Operating Company, LLC
NPI 1871035485 · Skilled Nursing Facility · Ticonderoga, NY
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
1019 Wicker Street Operating Company, LLC is a Skilled Nursing Facility organization in Ticonderoga, NY (NPI 1871035485).
Provider details
- NPI number
- 1871035485
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jeffrey Rubin, Co-Chief Executive Officer(716) 817-5075
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Elderwood at Ticonderoga
- Doing business as
- Elderwood at Ticonderoga
Registry dates
- Enumerated
- 2016-11-14
- Last updated
- 2023-01-19
- Certified
- 2023-01-19
Frequently asked questions
- What is 1019 Wicker Street Operating Company, LLC's NPI number?
- 1019 Wicker Street Operating Company, LLC's National Provider Identifier (NPI) is 1871035485, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 1019 Wicker Street Operating Company, LLC?
- 1019 Wicker Street Operating Company, LLC is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is 1019 Wicker Street Operating Company, LLC located?
- 1019 Wicker Street Operating Company, LLC's practice location on file with NPPES is 1019 Wicker St, Ticonderoga, NY 12883-1039.
- What is 1019 Wicker Street Operating Company, LLC's phone number?
- The practice phone number listed in the NPPES registry for 1019 Wicker Street Operating Company, LLC is (518) 585-2831.
- Does 1019 Wicker Street Operating Company, LLC accept Medicare?
- 1019 Wicker Street Operating Company, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for 1019 Wicker Street Operating Company, LLC?
- The authorized official listed on 1019 Wicker Street Operating Company, LLC's NPPES record is Jeffrey Rubin, Co-Chief Executive Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 1019 Wicker Street Operating Company, LLC's NPI active?
- Yes — 1019 Wicker Street Operating Company, LLC's NPI (1871035485) is active in the NPPES registry as of the last update on 2023-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.