Post Acute Specialty Hospital of Victoria LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

Legal business name

POST ACUTE SPECIALTY HOSPITAL OF VICTORIA LLC

Doing business as

PAM Specialty Hospital of Victoria South

Practice address

506 E San Antonio St
3Rd Floor
Victoria, TX 77901-6060

Phone

(361) 575-1445

Fax

(361) 570-1847

NPI assigned

Aug 8, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Anthony F Misitano

Title

President

Phone

(717) 731-9660

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PAM Specialty Hospital of Victoria South Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 452056

Legal name

PAM SPECIALTY HOSPITAL OF VICTORIA SOUTH

Certification status

Terminated Voluntary: merger or closure, Jun 1, 2024

Provider type (POS)

Hospital – Long-term

Participating since

Oct 10, 1997

Last certification

Jul 12, 2021

Beds

23

Ownership / control type

Private (for profit)

Most recent change of ownership

Sep 25, 2013 (1 total)

Facility address

506 East San Antonio Street 3Rd Floor
Victoria, TX 77901

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1417389784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 GOOD HOPE RD",
            "address_2": "SUITE 102",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251233",
            "telephone_number": "717-731-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E SAN ANTONIO ST",
            "address_2": "3RD FLOOR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016060",
            "telephone_number": "361-575-1445",
            "fax_number": "361-570-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POST ACUTE SPECIALTY HOSPITAL OF VICTORIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "MISITANO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-731-9660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331384301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331384302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Specialty Hospital of Victoria South",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAM Specialty Hospital of Victoria South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shandi Polak, SLP
• Vincent McAdam Porter
• Jennifer Michelle Pospisil, PHARMD
• Post Acute Medical at Victoria LLC (PAM Specialty Hospital of Victoria North)
• Post Acute Medical at Victoria, LLC (Warm Springs Specialty Hospital of Victoria)
• Brett Russell Potter, DMD
• Potts Speech Pathology Associates, P.C. (Meredith Potts, M.A., CCC-SLP)
• Meredith Potts, M.A., CCC-SLP
• Charlotte Anne Powell, LPC
• Christopher Pratka, M.D.

• Long Term Care Hospital in Victoria, TX
• Providers in Victoria, TX by specialty
• Long Term Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.