NPIMap

Organization Active NPI

Prime Healthcare Services - St Francis LLC

Doing business as St Francis Medical Center

  • General Acute Care Hospital
  • Lynwood, CA
National Provider Identifier
1114547114
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PRIME HEALTHCARE SERVICES - ST FRANCIS LLC
Doing business as
St Francis Medical Center
Practice address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Phone
(310) 900-8900
NPI assigned
Apr 20, 2020
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

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

Addresses

Primary practice location

3630 E Imperial Hwy
Lynwood, CA 90262-2609

Mailing address

3480 E Guasti Rd
Ontario, CA 91761-7684
Phone (909) 235-4400

Other identifiers 5

IdentifierTypeStateIssuer
HSM30104GMedicaidCA
LTC55238GMedicaidCA
ZZT40104GMedicaidCA
HSC30104GMedicaidCA
ZZT30104GMedicaidCA

Other names 1

  • St Francis Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161101002657 CA Part B Supplier - Clinic/Group Practice 4082992623 Receives reassigned benefits from 49 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Upland, CA; Victorville, CA; San Dimas, CA; San Bernardino, CA; Pomona, CA; Banning, CA; Loma Linda, CA; Riverside, CA…
O20200916002169 CA Part A Provider - Hospital 1153751375 Practice locations: Lynwood, CA; South Gate, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114547114. Details of each certification follow.

Hospital certification: CCN 050104

Legal name
PRIME HEALTHCARE SERVICES - ST FRANCIS LLC
Doing business as
ST. FRANCIS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 26, 2018
Beds
448
Ownership / control type
Church
Most recent change of ownership
Oct 27, 2020 (2 total)
Organization structure
LLCProprietary
Incorporated
Apr 14, 2020 in DE
Enrollment address
3630 E Imperial Hwy
Lynwood, CA 90262-2609
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Saint Francis Medical CenterCCN 050104 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - St Francis LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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 8

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, Chain home office 5% Or Greater Direct Ownership Interest Apr 16, 2020 100%
Kasp Trust No 2 Organization, Ontario, CA 5% Or Greater Indirect Ownership Interest Apr 14, 2020 33.3%
Luis Leon Individual Corporate OfficerChief Executive Officer Apr 14, 2020
Corporate DirectorChief Executive Officer Apr 14, 2020
W-2 Managing EmployeeChief Executive Officer Apr 14, 2020
Steven Aleman Individual Corporate OfficerChief Financial Office Apr 14, 2020
Kasp Trust No 3 Organization, Ontario, CA 5% Or Greater Indirect Ownership Interest Apr 14, 2020 33.3%
Kasp Trust No 1 Organization, Ontario, CA 5% Or Greater Indirect Ownership Interest Apr 14, 2020 33.3%
Christopher Doan Individual Corporate OfficerManaging Associate General Couns Apr 14, 2020
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Apr 14, 2020 100%

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Practitioners 3

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 218

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

View all 218

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1114547114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 E GUASTI RD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617684",
            "telephone_number": "909-235-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622609",
            "telephone_number": "310-900-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - ST FRANCIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSM30104G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55238G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40104G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30104G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30104G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Francis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Francis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.