NPIMap

Organization Active NPI

Premier at Susquehanna for Nursing and Rehabilitation LLC

  • Skilled Nursing Facility
  • Millersburg, PA
National Provider Identifier
1699292706
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PREMIER AT SUSQUEHANNA FOR NURSING AND REHABILITATION LLC
Practice address
990 Medical Rd
Millersburg, PA 17061-1235
Phone
(717) 691-4751
NPI assigned
Aug 29, 2017
Last updated
Aug 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Authorized official

Name
Daniel Schaffer
Title
Manager
Phone
(516) 505-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

990 Medical Rd
Millersburg, PA 17061-1235

Mailing address

600 Broadway Unit E
Lynbrook, NY 11563-3980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171019002486 PA Part A Provider - Skilled Nursing Facility 0648546507 Practice locations: Millersburg, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699292706. Details of each certification follow.

Skilled nursing facility certification: CCN 395428

Legal name
PREMIER AT SUSQUEHANNA FOR NURSING AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1979
Last certification
Jul 11, 2024
Beds
194
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jul 17, 2017 in DE
Enrollment address
990 Medical Road
Millersburg, PA 17061-1235
Nursing home name
NORTHERN DAUPHIN NURSING AND REHABILITATION CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Northern Dauphin Nursing and Rehabilitation CenterCCN 395428 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
194166.3 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $11,921

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Akiva Tzvi Glatzer Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
Premier Members Organization, Valley Stream, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 18, 2017 100%
Priority Care Group LLC Organization, Howell, NJ LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2019
Robert a Ettlinger Individual Operational/Managerial Control Sep 18, 2017
Adp of the SNF Jun 11, 2025
Summation Financial Services LLC Organization, Howell, NJ LLC, Management services company, For-profit Operational/Managerial Control Jan 1, 2019
Adp of the SNF Jun 11, 2025
990 Medical Road Propco LLC Organization, Lynbrook, NY LLC, For-profit Adp of the SNF Sep 18, 2017
Kathleen Gamzeh Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
El Buckeye East LLC Organization, Lawrence, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%
Pamela Dalberto Individual Operational/Managerial Control Apr 13, 2024
Adp of the SNF Apr 7, 2025
Clinical Consulting Services LLC Organization, Eddystone, PA LLC, Consulting firm, For-profit Operational/Managerial Control Jan 1, 2019
Adp of the SNF Jun 11, 2025
Daniel Schaffer Individual 5% Or Greater Indirect Ownership Interest Sep 18, 2017 25%

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 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 2

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": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1699292706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY UNIT E",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 MEDICAL RD",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "170611235",
            "telephone_number": "717-691-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER AT SUSQUEHANNA FOR NURSING AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-505-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersburg, PA

Sources for this page

Verify at the official NPI Registry.