Absolut Center for Nursing and Rehabilitation at Gasport, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3158302N Issued in NY

Legal business name

ABSOLUT CENTER FOR NURSING AND REHABILITATION AT GASPORT, LLC

Practice address

4540 Lincoln Dr
Gasport, NY 14067-9212

Phone

(716) 772-2631

Fax

(716) 772-2054

NPI assigned

Feb 28, 2007

Last updated

Oct 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Israel Sherman

Title

Managing Member

Phone

(716) 652-2820

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417084237. Details of each certification follow.

• CCN 335533001 Skilled nursing facility · Details

Skilled nursing facility certification: CCN 335533001

Legal name

ABSOLUT AT GASPORT, LLC

Organization structure

LLCProprietary

Enrollment address

4540 Lincoln Dr
Gasport, NY 14067-9212

Nursing home name

ABSOLUT CENTER FOR NURSING AND REHABILITATION AT GASPORT, LLC

Affiliated entity

ABSOLUT CARE

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 4

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

Facilities with the same owner 4

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

• Absolut Center for Nursing and Rehabilitation at Allegany, LLC

  • Skilled Nursing Facility
  • Allegany, NY
  • NPI 1881721611

  Absolut Facilities Management, LLC

  CMS ownership
• Absolut Center for Nursing and Rehabilitation at Aurora Park, LLC

  • Skilled Nursing Facility
  • East Aurora, NY
  • NPI 1558406009

  Absolut Facilities Management, LLC

  CMS ownership
• Absolut Center for Nursing and Rehabilitation at Endicott, LLC

  • Skilled Nursing Facility
  • Endicott, NY
  • NPI 1427185248

  Absolut Facilities Management, LLC

  CMS ownership
• Absolut Center for Nursing and Rehabilitation at Three Rivers, LLC

  • Skilled Nursing Facility
  • Painted Post, NY
  • NPI 1619004439

  Absolut Facilities Management, LLC

  CMS ownership

Practitioners 1

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.

• Harnath Balendra Clerk, MD

  • Internal Medicine Physician
  • Newfane, NY
  • NPI 1407801798
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1417084237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GLEED AVE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140522980",
            "telephone_number": "716-652-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 LINCOLN DR",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679212",
            "telephone_number": "716-772-2631",
            "fax_number": "716-772-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSOLUT CENTER FOR NURSING AND REHABILITATION AT GASPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "716-652-2820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "3158302N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000254002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6V",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01514718",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY CHOICE SKILLED",
            "identifier": "6V",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA/EXCELLUS",
            "identifier": "00011428902",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "7100369",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY CHOICE SUBACUTE",
            "identifier": "W4",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://urldefense.com/v3/__https:/esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service__;!!FxBh9b0Dhg!YNotywZTQPco5y2YH7CAn8wZy0i1ML5ZmZIiOGVTb0SyRowZCFpsAtBlzL-QcKJNaAltZDIuQMBfPiPbhbW77CgYe44hv0U$",
            "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": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Irina Ardelean-Growden, DDS
• Angela Botting, M.S.ED
• Stacy L Braham, LPN
• Nicole Buhr
• Deborah Sue Capell

• Skilled Nursing Facility in Gasport, NY
• Providers in Gasport, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.