NPIMap

Organization Active NPI

Goldwater Care Bloomington LLC

Doing business as Goldwater Care Bloomington

  • Skilled Nursing Facility
  • Bloomington, IL
National Provider Identifier
1396439097
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 CARE BLOOMINGTON LLC
Doing business as
Goldwater Care Bloomington
Practice address
700 E Walnut St
Bloomington, IL 61701-3244
Phone
(309) 827-8004
NPI assigned
Jun 6, 2023
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

700 E Walnut St
Bloomington, IL 61701-3244

Mailing address

4655 W Chase Ave
Lincolnwood, IL 60712-1605
Phone (847) 262-3800

Other names 1

  • Goldwater Care Bloomington 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
O20231109002136 IL Part A Provider - Skilled Nursing Facility 4183071392 Practice locations: Bloomington, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396439097. Details of each certification follow.

Skilled nursing facility certification: CCN 145016

Legal name
GOLDWATER CARE BLOOMINGTON LLC
Doing business as
GOLDWATER CARE BLOOMINGTON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Feb 26, 2025
Beds
88
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Goldwater Care
Organization structure
LLCProprietary
Enrollment address
700 E Walnut St
Bloomington, IL 61701-3244
Nursing home name
GOLDWATER CARE BLOOMINGTON
Affiliated entity
GOLDWATER CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Goldwater Care BloomingtonCCN 145016 · 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, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8872.5 residents per day on average
Chain
Goldwater Care11 facilities in the chain
Penalties (3 years)
6Fines totaling $234,633

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 19

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 Jul 1, 2023 100%
Operational/Managerial ControlVP of Revenue Cycle Management Jul 1, 2023 100%
Adp of the SNF Jul 1, 2023
Jan Marie Joaquin Individual Operational/Managerial Control Jul 1, 2023
Managing Control - Governing BodyAdministrator Jul 1, 2023
Adp of the SNF Jul 1, 2023
David a Berkowitz Revoc TR David Berkowitz Ttee Organization, Lincolnwood, IL Adp of the SNF Jan 1, 2023
Aaron Tversky Individual 5% Or Greater Direct Ownership InterestPrincipal Jul 1, 2023 35%
Operational/Managerial Control Jan 1, 2023
Managing Control - Governing BodyPrincipal Jul 1, 2023
Adp of the SNF Jul 1, 2023
Yosef Meystel Declaration of TR of Yosef Meystel Ttee Organization, Lincolnwood, IL Direct Ownership Interest Jul 1, 2023 25%
Meir Katzenstein Individual 5% Or Greater Direct Ownership InterestPrincipal Jul 1, 2023 35%
Operational/Managerial Control Jul 1, 2023
Managing Control - Governing BodyPrincipal Jul 1, 2023
Adp of the SNF Jul 1, 2023
700 E. Walnut St., LLC Organization, Lincolnwood, IL LLC Adp of the SNF Mar 19, 2025
Steven C Ingalsbe Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Jul 1, 2023
Brian Goldfarb Individual Direct Ownership Interest Jul 1, 2023 1%
Steven Turofsky Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Jul 1, 2023
Yosef Meystel Delta Trust Organization, Lincolnwood, IL Adp of the SNF Jul 1, 2023
Direct Ownership Interest Jul 1, 2023 24.5%
David a Berkowitz Delta Trust Organization, Lincolnwood, IL Adp of the SNF Jul 1, 2023
Direct Ownership Interest Jul 1, 2023 4.5%
Goldwater Care Management LLC Organization, Lincolnwood, IL LLC, Management services company, Consulting firm, Chain home office Operational/Managerial Control Jul 1, 2023
Adp of the SNF Mar 19, 2025
Heidi Lock Individual Operational/Managerial Control Jul 1, 2023
Managing Control - Governing BodyDirector of Nursing Jul 1, 2023
Adp of the SNF Jul 1, 2023
Naftali Wilhelm Individual Operational/Managerial Control Jul 1, 2023
Adp of the SNF Jul 1, 2023
Curis Services LLC Organization, Lincolnwood, IL LLC, Consulting firm Adp of the SNF Jul 1, 2023
Melissa Anne Stachowiak Individual Managing Control - Governing BodyRegional Director of Operations Jul 1, 2023
Adp of the SNF Jul 1, 2023
Aperion Care Exec Holdings LLC Organization, Lincolnwood, IL LLC Adp of the SNF Jul 1, 2023
Joshua Hoffman Trust Organization, Chicago, IL Adp of the SNF Jul 1, 2023

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 10

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

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": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1396439097",
    "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": "847-262-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013244",
            "telephone_number": "309-827-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDWATER CARE BLOOMINGTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "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 Care Bloomington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.