NPIMap

Organization Active NPI

Pam Rehabilitation Hospital of Wausau LLC

  • Rehabilitation Hospital
  • Wausau, WI
National Provider Identifier
1831878628
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
PAM REHABILITATION HOSPITAL OF WAUSAU LLC
Practice address
1111 Westwood Drive
Wausau, WI 54401
Phone
(717) 731-9660
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Anthony Misitano
Title
President
Phone
(717) 731-9660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

1111 Westwood Drive
Wausau, WI 54401

Mailing address

1828 Good Hope Rd Ste 102
Enola, PA 17025-1203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231215000095 WI Part A Provider - Hospital 6507215522 Practice locations: Wausau, WI

Hospital certification: CCN 523034

Legal name
PAM REHABILITATION HOSPITAL OF WAUSAU LLC
Doing business as
PAM HEALTH REHABILTATION HOSPITAL OF WAUSAU
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
May 30, 2024
Last certification
May 30, 2024
Beds
42
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Apr 21, 2021 in PA
Enrollment address
1111 Westwood Dr
Wausau, WI 54401-7804
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Pam Health Rehabilitation Hospital of WausauCCN 523034
Ownership
For profit
Certified
May 30, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2296859Pam Health Rehabilitation Hospital of Wausau1111 Westwood Drive, Wausau, WI 54401Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Laura Zindars Individual W-2 Managing EmployeeAd; Nov 29, 2024
Karick E Stober Individual Corporate Officer Apr 21, 2021 4.5%
Anthony F Misitano Individual Corporate Officer Apr 21, 2021 1%
Pam Cubed LLC Organization, Enola, PA LLC, Holding company, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 21, 2021 100%
Wells Fargo Bank, N.a. Organization, Minneapolis, MN Financial institution 5% Or Greater Security Interest Jul 23, 2024
Brittany Misitano Individual 5% Or Greater Indirect Ownership Interest Apr 21, 2021 73.5%
Corporate Officer Apr 21, 2021

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

Affiliated clinicians 5

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1831878628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 GOOD HOPE RD STE 102",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WESTWOOD DRIVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "717-731-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM REHABILITATION HOSPITAL OF WAUSAU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "MISITANO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-731-9660"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.