Southport Center for Nursing & Rehabilitation, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SOUTHPORT CENTER FOR NURSING & REHABILITATION, LLC

Practice address

930 Mill Hill Ter
Southport, CT 06890-1265

Phone

(203) 259-7894

NPI assigned

May 27, 2021

Organization subpart

No

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

Authorized official

Name

Menajem Salamon

Title

Principal

Phone

(718) 882-6400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Skilled nursing facility certification: CCN 075200

Legal name

SOUTHPORT CENTER FOR NURSING & REHABILITATION LLC

Doing business as

SOUTHPORT CENTER FOR NURSING AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 1, 1977

Last certification

Nov 16, 2022

Beds

120

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Feb 23, 2021 in CT

Enrollment address

930 Mill Hill Ter
Southport, CT 06890-1265

Nursing home name

SOUTHPORT CENTER FOR NURSING & REHABILITATION LLC

Affiliated entity

ESSENTIAL HEALTHCARE

Listed as

Southport Center For Nursing & Rehabilitation LlcCCN 075200 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jun 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120109.2 residents per day on average

Chain

Essential Healthcare6 facilities in the chain

Penalties (3 years)

1Fines totaling $13,757

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 12

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.

• George M Goldfarb, MD

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1194750471

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 4

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

• George M Goldfarb, MD

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1194750471

  Nursing home

  Care Compare affiliation
• Rahul Gupta, M.D.

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1245421213

  Nursing home

  Care Compare affiliation
• Adrian Wolodymyr Klufas, MD

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1396731642

  Nursing home

  Care Compare affiliation
• Alfred Bircaj, MD

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1154568707

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1386210755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MILL HILL TER",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901265",
            "telephone_number": "203-259-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MILL HILL TER",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901265",
            "telephone_number": "203-259-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPORT CENTER FOR NURSING & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "SALAMON",
        "authorized_official_first_name": "MENAJEM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "718-882-6400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000008508",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Skyline Behavioral Health
• Linda S Smith, PH.D.
• Joelle Smorada, LCSW
• Daniel William Snow, LCSW
• Sarah Sotomayor
• Southport Smiles Dentistry, P.C.
• Southport Smiles P.C.
• Southport Surgery Center LLC
• David Spengler, OD
• Kristina Sullivan

• Skilled Nursing Facility in Southport, CT
• Providers in Southport, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.