NPIMap

Organization Active NPI

Prime Healthcare Centinela LLC

Doing business as Centinela Hospital Medical Center

  • Rehabilitation Hospital Unit
  • Inglewood, CA
National Provider Identifier
1104005990
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
PRIME HEALTHCARE CENTINELA LLC
Doing business as
Centinela Hospital Medical Center
Practice address
555 E Hardy St
Inglewood, CA 90301-4011
Phone
(310) 680-1488
Fax
(310) 677-0535
NPI assigned
Oct 29, 2007
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Troy A Schell
Title
Secretary / General Counsel
Phone
(909) 235-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X CA Primary

Addresses

Primary practice location

555 E Hardy St
Inglewood, CA 90301-4011

Mailing address

555 E Hardy St
Inglewood, CA 90301-4011
Phone (310) 673-4660

Other names 1

  • Centinela Hospital 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
O20130405000460 CA Part A Provider - Hospital 2567559875 Practice locations: Inglewood, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104005990. Details of each certification follow.

Hospital certification: CCN 05T739

Legal name
PRIME HEALTHCARE CENTINELA LLC
Doing business as
CENTINELA HOSPITAL MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
Jun 26, 2007 in DE
Enrollment address
555 East Hardy St
Inglewood, CA 90301-4011
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

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: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Centinela Hospital Medical CtrCCN 05T739 · All quality measures
Ownership
For profit
Certified
Jan 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Centinela LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the 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
Prime Healthcare Centinela LLC Organization, Inglewood, CA 5% Or Greater Direct Ownership Interest Aug 27, 2020
Luis Leon Individual Corporate OfficerChief Executive Officer Jun 1, 2020
Steven Aleman Individual Corporate OfficerCorporate Chief Financial Officer Jun 1, 2020
Paul M Sennett Individual W-2 Managing EmployeeCfo Jan 1, 2013
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Apr 24, 2017
Mohammad Naser Individual Corporate OfficerChief Executive Officer May 1, 2019
Corporate DirectorChairman of the Board May 1, 2019
W-2 Managing EmployeeChief Executive Officer May 1, 2019

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Centinela Hospital Medical CenterInglewood, CA, CCN 050739 Hospital 5% Or Greater Direct Ownership Interest Nov 1, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1104005990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E HARDY ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014011",
            "telephone_number": "310-673-4660",
            "fax_number": "310-677-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E HARDY ST",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014011",
            "telephone_number": "310-680-1488",
            "fax_number": "310-677-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE CENTINELA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "SCHELL",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SECRETARY / GENERAL COUNSEL",
        "authorized_official_telephone_number": "909-235-4311"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centinela Hospital Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.