NPIMap

Organization Active NPI

Post Acute Medical at Nanticoke LLC

Doing business as PAM Specialty Hospital of Wilkes-Barre

  • Long Term Care Hospital
  • Wilkes Barre, PA
National Provider Identifier
1750798740
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
POST ACUTE MEDICAL AT NANTICOKE LLC
Doing business as
PAM Specialty Hospital of Wilkes-Barre
Practice address
575 N River St
7TH Floor
Wilkes Barre, PA 18764-2634
Phone
(570) 208-3310
NPI assigned
Jul 22, 2014
Last updated
Aug 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Long Term Care Hospital 282E00000X NU Primary

Addresses

Primary practice location

575 N River St
7TH Floor
Wilkes Barre, PA 18764-2634

Mailing address

1828 Good Hope Rd
Suite 102
Enola, PA 17025-1233
Phone (717) 731-9660

Other identifiers 1

IdentifierTypeStateIssuer
103067848-0002MedicaidPA

Other names 1

  • PAM Specialty Hospital of Wilkes-Barre Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141027000841 PA Part A Provider - Hospital 9032330501 1 other NPI on this enrollment
Practice locations: Wilkes-Barre, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750798740. Details of each certification follow.

Hospital certification: CCN 392025

Legal name
POST ACUTE MEDICAL AT NANTICOKE, LLC
Doing business as
PAM SPECIALTY HOSPITAL OF WILKES-BARRE
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jan 1, 1994
Last certification
Mar 26, 2024
Beds
36
Ownership / control type
Private (for profit)
Most recent change of ownership
Nov 3, 2014 (2 total)
Organization structure
LLCProprietary
Incorporated
Dec 19, 2013 in DE
Enrollment address
575 North River St
7TH Floor
Wilkes-Barre, PA 18764-0999
Other Hospital Practice Location
Hospital subgroups
Long-term

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Pam Specialty Hospital of Wilkes-BarreCCN 392025 · All quality measures
Ownership
For profit
Certified
Jan 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Beds
36

National Provider Directory

National Provider Directory
Tax ID family
Post Acute Medical at Nanticoke LLC2 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 10

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

NameRoleSinceShare
Ba Healthcare Holdings, LLC Organization, Enola, PA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 3, 2014 50%
Post Acute Medical, LLC Organization, Enola, PA LLC, For-profit 5% Or Greater Direct Ownership Interest Nov 3, 2014 100%
David Long Individual W-2 Managing Employee Apr 17, 2019
Karick E Stober Individual Corporate OfficerVice President/Treasurer Nov 3, 2014
Anthony F Misitano Individual 5% Or Greater Indirect Ownership Interest Nov 3, 2014 50%
Corporate OfficerPresident Nov 3, 2014
Pam Cubed LLC Organization, Enola, PA LLC, For-profit 5% Or Greater Indirect Ownership Interest Jul 23, 2024 50%
John E Bauer Individual Corporate OfficerVice President/Secretary Nov 3, 2014
Wells Fargo Bank, N.a. Organization, Minneapolis, MN Financial institution 5% Or Greater Security Interest Jul 23, 2024
Post Acute Medical Management, LLC Organization, Enola, PA LLC, For-profit Operational/Managerial Control Nov 3, 2014
Brittany Misitano Individual 5% Or Greater Indirect Ownership Interest Jul 23, 2024

Facilities with the same owner 42

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

View all 42

Practitioners & affiliated clinicians

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.

Affiliated clinicians 4

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": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1750798740",
    "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": "575 N RIVER ST",
            "address_2": "7TH FLOOR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187642634",
            "telephone_number": "570-208-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POST ACUTE MEDICAL AT NANTICOKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103067848-0002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Specialty Hospital of Wilkes-Barre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.