NPIMap

Organization Active NPI

Clear Lake Institute for Rehabilitation LLC

Doing business as PAM Rehabilitation Hospital of Clear Lake

  • Rehabilitation Hospital
  • Webster, TX
National Provider Identifier
1861882532
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
CLEAR LAKE INSTITUTE FOR REHABILITATION LLC
Doing business as
PAM Rehabilitation Hospital of Clear Lake
Practice address
110 E Medical Center Blvd
Webster, TX 77598-4301
Phone
(832) 224-9500
Fax
(832) 224-9510
NPI assigned
Feb 2, 2015
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Rehabilitation Clinic/Center 261QR0400X
General Acute Care Hospital 282N00000X
Rehabilitation Hospital 283X00000X TX Primary
Special Hospital 284300000X

Addresses

Primary practice location

110 E Medical Center Blvd
Webster, TX 77598-4301

Mailing address

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

Other practice location 1

655 E Medical Center Blvd
Webster, TX 77598-4328
Phone (281) 286-1500

Other practice location 2

18839 McKay Dr
Humble, TX 77338-5721
Phone (281) 964-6600

Other names 1

  • PAM Rehabilitation Hospital of Clear Lake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150527000562 TX Part A Provider - Hospital 8325368707 Practice locations: Humble, TX; Webster, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861882532. Details of each certification follow.

Hospital certification: CCN 673061

Legal name
CLEAR LAKE INSTITUTE FOR REHABILITATION LLC
Doing business as
PAM REHABILITATION HOSPITAL OF CLEAR LAKE
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Aug 20, 2015
Last certification
Oct 18, 2024
Beds
45
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Apr 1, 2014 in DE
Enrollment address
110 East Medical Center Boulevard
Webster, TX 77598-4301
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Pam Rehabilitation Hospital of Clear LakeCCN 673061 · All quality measures
Ownership
For profit
Certified
Aug 20, 2015
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Karick E Stober Individual Corporate OfficerVice President Treasurer May 15, 2014
Anthony F Misitano Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2021 65.57%
Corporate OfficerPresident May 15, 2014
Pam Cubed LLC Organization, Enola, PA Chain home office Other Apr 1, 2024
John E Bauer Individual Corporate Officer May 15, 2014
Wells Fargo Bank, N.a. Organization, Minneapolis, MN 5% Or Greater Security Interest Jul 23, 2024
Pam Rehabilitation Hospital at Webster, LLC Organization, Enola, PA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2023 100%
Alyson Case Individual W-2 Managing EmployeeCeo Apr 7, 2025
Pam Squared, LLC Organization, Enola, PA LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2018 100%

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 9

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 61

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1861882532",
    "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": "110 E MEDICAL CENTER BLVD",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984301",
            "telephone_number": "832-224-9500",
            "fax_number": "832-224-9510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984328",
            "country_code": "US",
            "telephone_number": "281-286-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18839 McKay Dr",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773385721",
            "country_code": "US",
            "telephone_number": "281-964-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLEAR LAKE INSTITUTE FOR REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Rehabilitation Hospital of Clear Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAM Rehabilitation Hospital of Clear Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.