NPIMap

Organization Active NPI

Ellen Memorial, LLC

Doing business as Ellen Memorial Health Care Center

  • Skilled Nursing Facility
  • Honesdale, PA
National Provider Identifier
1942763297
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ELLEN MEMORIAL, LLC
Doing business as
Ellen Memorial Health Care Center
Practice address
23 Ellen Memorial LN
Honesdale, PA 18431-4096
Phone
(570) 253-5690
NPI assigned
Apr 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Mr. James Miller, NHA
Title
Administrator
Phone
(570) 947-7043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

23 Ellen Memorial LN
Honesdale, PA 18431-4096

Mailing address

23 Ellen Memorial LN
Honesdale, PA 18431-4096
Phone (570) 253-5690

Other names 1

  • Ellen Memorial Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190514002452 PA Part A Provider - Skilled Nursing Facility 2365785359 Practice locations: Honesdale, PA

Skilled nursing facility certification: CCN 395357

Legal name
ELLEN MEMORIAL LLC
Doing business as
ELLEN MEMORIAL HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 21, 1976
Last certification
Jan 10, 2025
Beds
128
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Mar 2, 2019 in PA
Enrollment address
23 Ellen Memorial LN
Honesdale, PA 18431-4096

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ellen Memorial Rehabilitation and Healthcare CenteCCN 395357 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 21, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
128115.7 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

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
39D1064065Ellen Memorial Rehab and Healthcare Center23 Ellen Memorial Lane, Honesdale, PA 18431Certificate of waiverJan 28, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Richard S Buckman Individual 5% Or Greater Direct Ownership Interest May 31, 2019 92.5%
Corporate OfficerCeo May 31, 2019 92.5%
Shira Lynne Lipperini Ramirez Individual W-2 Managing EmployeeNha May 31, 2019 100%
Charles Galat Individual 5% Or Greater Direct Ownership Interest May 31, 2019 7.5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1942763297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ELLEN MEMORIAL LN",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184314096",
            "telephone_number": "570-253-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ELLEN MEMORIAL LN",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184314096",
            "telephone_number": "570-253-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN MEMORIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-12",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-947-7043",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellen Memorial Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellen Memorial Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honesdale, PA

Sources for this page

Verify at the official NPI Registry.