NPIMap

Organization Active NPI

Alta Newport Hospital, LLC

Doing business as Foothill Regional Medical Center

  • General Acute Care Hospital
  • Tustin, CA
National Provider Identifier
1043632938
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
060000178 Issued in CA
Legal business name
ALTA NEWPORT HOSPITAL, LLC
Doing business as
Foothill Regional Medical Center
Practice address
14662 Newport Ave
Tustin, CA 92780-6064
Phone
(714) 619-7700
Fax
(714) 619-7724
NPI assigned
Jan 10, 2014
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Robert Jon Elders
Title
Secretary
Phone
(714) 788-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 060000178 CA Primary

Addresses

Primary practice location

14662 Newport Ave
Tustin, CA 92780-6064

Mailing address

3415 S Sepulveda Blvd FL 9
Los Angeles, CA 90034-6060
Phone (310) 943-4500

Other names 1

  • Foothill Regional Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150701002328 CA Part A Provider - Hospital 5395975825 Practice locations: Tustin, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043632938. Details of each certification follow.

Hospital certification: CCN 050780

Legal name
ALTA NEWPORT HOSPITAL LLC
Doing business as
FOOTHILL REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 24, 2015
Last certification
Aug 31, 2021
Beds
135
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Nov 11, 2013 in CA
Enrollment address
14662 Newport Ave
Tustin, CA 92780-6064
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Foothill Regional Medical CenterCCN 050780 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Alta Newport Hospital 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.

Locations

1211 W La Palma Ave
Ste 306
Anaheim, CA 92801
Phone (714) 778-1300

1211 W La Palma Ave
Ste 707
Anaheim, CA 92801
Phone (714) 776-2100

710 N Euclid St
Ste 301
Anaheim, CA 92801
Phone (714) 517-2000

100 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 447-5027

1149 W 190th St
Ste 2000
Gardena, CA 90248
Phone (424) 329-0074

16300 Sand Canyon Ave
Ste 604
Irvine, CA 92618
Phone (949) 336-8761

2040 Pacific Coast Hwy
Ste S
Lomita, CA 90717
Phone (424) 347-8008

1386 W 7th St
Ste 100
San Pedro, CA 90732

999 N Tustin Ave
Ste 1
Santa Ana, CA 92705
Phone (714) 836-6800

1830 Commercenter E
Sn Bernrdno, CA 92408
Phone (877) 414-3007

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Robert Elders Individual Corporate OfficerVP, Legal Jun 15, 2020
Glenda Luce Individual W-2 Managing EmployeeHospital Chief Nursing Officer Aug 18, 2014
Astrana Health Inc Organization, Alhambra, CA Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2025 100%
Araceli Lonergan Individual W-2 Managing EmployeeHospital Ceo Jul 10, 2017
Astrana Care Hospital, LLC Organization, Alhambra, CA Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2025 100%

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 92

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.

View all 92

Affiliated clinicians 101

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

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1043632938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 S SEPULVEDA BLVD FL 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346060",
            "telephone_number": "310-943-4500",
            "fax_number": "310-943-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14662 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806064",
            "telephone_number": "714-619-7700",
            "fax_number": "714-619-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA NEWPORT HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "060000178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foothill Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.