NPIMap

Organization Active NPI

Goldwater Pontiac Nursing Home LLC

Doing business as Goldwater Pontiac Nursing Home

  • Skilled Nursing Facility
  • Pontiac, IL
National Provider Identifier
1184345928
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GOLDWATER PONTIAC NURSING HOME LLC
Doing business as
Goldwater Pontiac Nursing Home
Goldwater Care Pontiac
Practice address
1225 S Ewing Dr
Pontiac, IL 61764-9701
Phone
(815) 844-5121
NPI assigned
Sep 9, 2022
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Jennifer Spector
Title
VP of Revenue Cycle Management
Phone
(847) 262-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1225 S Ewing Dr
Pontiac, IL 61764-9701

Mailing address

4655 W Chase Ave
Lincolnwood, IL 60712-1605
Phone (184) 726-2380

Other names 2

  • GOLDWATER PONTIAC NURSING HOME Doing business as
  • Goldwater Care Pontiac Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221110000789 IL Part A Provider - Skilled Nursing Facility 4284001819 Practice locations: Pontiac, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184345928. Details of each certification follow.

Skilled nursing facility certification: CCN 145930

Legal name
GOLDWATER PONTIAC NURSING HOME LLC
Doing business as
GOLDWATER PONTIAC NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1997
Last certification
May 16, 2024
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Goldwater Care
Organization structure
LLCProprietary
Enrollment address
1225 S Ewing Dr
Pontiac, IL 61764-9701
Nursing home name
GOLDWATER PONTIAC NURSING HOME
Affiliated entity
GOLDWATER CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Goldwater Pontiac Nursing HomeCCN 145930 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9084.5 residents per day on average
Chain
Goldwater Care11 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 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.

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Jennifer Spector Individual Corporate OfficerChief Revenue Officer Oct 1, 2022 100%
Operational/Managerial ControlVP of Revenue Cycle Management Oct 1, 2022 100%
Adp of the SNF Oct 1, 2022
1225 S Ewing Drive, LLC Organization, Lincolnwood, IL LLC Adp of the SNF Mar 28, 2025
David a Berkowitz Revoc TR David Berkowitz Ttee Organization, Lincolnwood, IL Direct Ownership Interest Oct 1, 2022 4.99%
Aaron Tversky Individual Corporate OfficerPrincipal Oct 1, 2022 100%
Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Erin Mays Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Meir Katzenstein Individual 5% Or Greater Direct Ownership InterestPrincipal Oct 1, 2022 55%
Corporate OfficerPrincipal Oct 1, 2022 100%
Operational/Managerial ControlCeo Oct 1, 2022 100%
Adp of the SNF Oct 1, 2022
Steven Turofsky Individual Operational/Managerial Control Oct 1, 2022
Muhammad Zafar Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Goldwater Care Management LLC Organization, Lincolnwood, IL LLC, Management services company, Consulting firm, Chain home office Operational/Managerial Control Oct 1, 2022
Adp of the SNF Mar 28, 2025
Yosef Meystel Declaration of TR of Yosef Meystel Ttee Organization, Lincolnwood, IL 5% Or Greater Direct Ownership Interest Oct 1, 2022 22.5%
Adp of the SNF Oct 1, 2022
Diana Devault Individual Operational/Managerial Control Oct 1, 2022
Managing Control - Governing BodyDirector of Nursing Oct 1, 2022
Adp of the SNF Oct 1, 2022
Naftali Wilhelm Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Curis Services LLC Organization, Lincolnwood, IL LLC, Consulting firm Adp of the SNF Oct 1, 2022
Melissa Anne Stachowiak Individual Managing Control - Governing BodyRegional Director of Operations Oct 1, 2022
Adp of the SNF Oct 1, 2022

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 31

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

View all 31

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1184345928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 W CHASE AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121605",
            "telephone_number": "184-726-2380",
            "fax_number": "847-996-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S EWING DR",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649701",
            "telephone_number": "815-844-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDWATER PONTIAC NURSING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "847-262-3800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GOLDWATER PONTIAC NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GOLDWATER PONTIAC NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Goldwater Care Pontiac",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pontiac, IL

Sources for this page

Verify at the official NPI Registry.