NPIMap

Organization Active NPI

Prime Healthcare Services Roxborough LLC

Doing business as Roxborough Memorial Hospital

  • General Acute Care Hospital
  • Philadelphia, PA
National Provider Identifier
1083986129
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PRIME HEALTHCARE SERVICES ROXBOROUGH LLC
Doing business as
Roxborough Memorial Hospital
Practice address
5800 Ridge Ave
Philadelphia, PA 19128-1737
Phone
(215) 483-9900
Fax
(909) 235-4419
NPI assigned
Feb 6, 2012
Last updated
May 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Michael Sarrao
Title
Vice-President
Phone
(909) 235-4400

Specialties & licenses 1

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

Addresses

Primary practice location

5800 Ridge Ave
Philadelphia, PA 19128-1737

Mailing address

5800 Ridge Ave
Philadelphia, PA 19128-1737
Phone (215) 483-9900

Other names 1

  • Roxborough Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120412000082 PA Part A Provider - Hospital 2567623994 Practice locations: Philadelphia, PA; East Norriton, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083986129. Details of each certification follow.

Hospital certification: CCN 390304

Legal name
PRIME HEALTHCARE SERVICES ROXBOROUGH LLC
Doing business as
ROXBOROUGH MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 19, 2002
Last certification
Oct 14, 2011
Beds
137 (107 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
Feb 22, 2012 (2 total)
Organization structure
LLCProprietary
Incorporated
Jan 12, 2012 in DE
Enrollment address
5800 Ridge Avenue
Philadelphia, PA 19128-1737
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric, Rehabilitation, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Roxborough Memorial HospitalCCN 390304 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2012 100%
Luis Leon Individual Corporate OfficerCorporate Chief Executive Officer Jun 1, 2020
Steven Aleman Individual Corporate OfficerCorporate Chief Financial Officer Jun 1, 2019
Darshan Parekh Individual Corporate OfficerChief Executive Officer Apr 1, 2024
Corporate DirectorDirector Apr 1, 2024
W-2 Managing EmployeeChief Executive Officer Apr 1, 2024
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Apr 24, 2017
Sonia C Mehta Individual Corporate OfficerRegional Chief Executive Officer Sep 28, 2018
W-2 Managing EmployeeRegional Chief Executive Officer Sep 28, 2018
Amanda B Buirge Individual Corporate OfficerChief Financial Officer May 2, 2022
W-2 Managing EmployeeChief Financial Officer May 2, 2022

Owners & managing parties with NPI records 1

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

Facilities with the same owner 75

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

View all 75

Practitioners & affiliated clinicians

Practitioners 17

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 17

Affiliated clinicians 102

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

View all 102

NPI Registry JSON

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

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1083986129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281737",
            "telephone_number": "215-483-9900",
            "fax_number": "909-235-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281737",
            "telephone_number": "215-483-9900",
            "fax_number": "909-235-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES ROXBOROUGH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "SARRAO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "909-235-4400"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roxborough Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.