NPIMap

Organization Active NPI

Premier at Perry Village for Nursing and Rehabilitation LLC

  • Skilled Nursing Facility
  • New Bloomfield, PA
National Provider Identifier
1073030185
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PREMIER AT PERRY VILLAGE FOR NURSING AND REHABILITATION LLC
Practice address
213 E Main St
New Bloomfield, PA 17068-9657
Phone
(717) 582-4346
NPI assigned
Aug 29, 2017
Last updated
Aug 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Authorized official

Name
Daniel Schaffer
Title
Manager
Phone
(516) 505-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

213 E Main St
New Bloomfield, PA 17068-9657

Mailing address

600 Broadway Unit E
Lynbrook, NY 11563-3980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020000080 PA Part A Provider - Skilled Nursing Facility 8022384908 Practice locations: New Bloomfield, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073030185. Details of each certification follow.

Skilled nursing facility certification: CCN 395426

Legal name
PREMIER AT PERRY VILLAGE FOR NURSING AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 18, 1979
Last certification
Dec 5, 2024
Beds
118
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jul 17, 2017 in DE
Enrollment address
213 East Main Street
New Bloomfield, PA 17068-9657
Nursing home name
PREMIER AT PERRY VILLAGE FOR NURSING AND REHAB, LL

Care Compare: Nursing home

Medicare Care Compare
Listed as
Premier at Perry Village for Nursing and Rehab, LLCCN 395426 · 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
For profit - Corporation
Certified
Jan 18, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
118107.4 residents per day on average
Penalties (3 years)
1Fines totaling $8,018

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
39D0657330Premier at Perry Village213 E Main Street, New Bloomfield, PA 17068Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Akiva Tzvi Glatzer Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
General Partnership Interest Sep 18, 2017
Steven Roy Creps Individual Operational/Managerial Control Sep 18, 2017
Adp of the SNF May 14, 2025
Premier Members Organization, Valley Stream, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 18, 2017 100%
Priority Care Group LLC Organization, Howell, NJ LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2019
Suzette C Brandt Individual Operational/Managerial Control Sep 18, 2017
Adp of the SNF Apr 7, 2025
Summation Financial Services LLC Organization, Howell, NJ LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2019
Adp of the SNF May 14, 2025
Kathleen Gamzeh Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
El Buckeye East LLC Organization, Lawrence, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
Clinical Consulting Services LLC Organization, Eddystone, PA LLC, Consulting firm, For-profit Operational/Managerial Control Jan 1, 2019
Adp of the SNF May 14, 2025
213 E Main Street Propco LLC Organization, Lynbrook, NY LLC, For-profit Adp of the SNF Sep 18, 2017
Daniel Schaffer Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
General Partnership Interest Sep 18, 2017

Owners & managing parties with NPI records 1

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

Facilities with the same owner 25

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

View all 25

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": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1073030185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY UNIT E",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 E MAIN ST",
            "city": "NEW BLOOMFIELD",
            "state": "PA",
            "postal_code": "170689657",
            "telephone_number": "717-582-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER AT PERRY VILLAGE FOR NURSING AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-505-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bloomfield, PA

Sources for this page

Verify at the official NPI Registry.