NPIMap

Organization Active NPI

Glendale Adventist Medical Center

  • Skilled Nursing Facility
  • Glendale, CA
National Provider Identifier
1114916293
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
930000059 Issued in CA
Legal business name
GLENDALE ADVENTIST MEDICAL CENTER
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 409-8000
Fax
(818) 546-5600
NPI assigned
Oct 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Alice Issai
Title
Ceo/President
Phone
(818) 409-8289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 930000059 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

Other identifiers 1

IdentifierTypeStateIssuer
LTC55419FMedicaidCA

Other names 1

  • Adventist Health Glendale Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170717002101 CA Part A Provider - Skilled Nursing Facility 4284692096 Practice locations: Glendale, CA

Skilled nursing facility certification: CCN 555911

Legal name
GLENDALE ADVENTIST MEDICAL CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Apr 18, 2019
Last certification
Aug 18, 2024
Beds
40
Ownership / control type
Partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 26, 1905 in CA
Enrollment address
1509 Wilson Ter
Glendale, CA 91206-4007
Nursing home name
GLENDALE ADVENTIST MEDICAL CENTER DP/SNF
Affiliated entity
ADVENTIST HEALTH

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Glendale Adventist Medical Center DP/SNFCCN 555911
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Apr 18, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4038.8 residents per day on average
Chain
Adventist Health5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations (25 of 40)

1658 W Valley Blvd
Ste 120
Alhambra, CA 91803

239 W Olive Ave
Burbank, CA 91502
Phone (818) 842-7999

1411 N Hollywood Way
Burbank, CA 91505
Phone (818) 238-2350

303 S Glenoaks Blvd
Ste 1
Burbank, CA 91502
Phone (818) 331-7687

2701 W Alameda Ave
Ste 407
Burbank, CA 91505
Phone (818) 842-8000

201 S Buena Vista St
Ste 238
Burbank, CA 91505
Phone (818) 325-2088

201 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 848-6404

2307 W Empire Ave
Burbank, CA 91504
Phone (818) 841-3420

500 E Olive Ave
Ste 750
Burbank, CA 91501
Phone (818) 244-4114

1680 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 401-6058

1577 E Chevy Chase Dr
Ste 350
Glendale, CA 91206

1510 S Central Ave
Ste 204
Glendale, CA 91204

1030 S Glendale Ave
Ste 505
Glendale, CA 91205
Phone (818) 500-0888

1560 E Chevy Chase Dr
Ste 245
Glendale, CA 91206
Phone (818) 246-5900

1505 Wilson Ter
Ste 150
Glendale, CA 91206
Phone (818) 275-4759

1808 Verdugo Blvd
Ste 102
Glendale, CA 91208
Phone (818) 952-1136

1530 E Chevy Chase Dr
Ste 107
Glendale, CA 91206
Phone (661) 705-9706

1030 S Glendale Ave
Ste 403
Glendale, CA 91205
Phone (818) 242-4426

1220 S Central Ave
Ste 105
Glendale, CA 91204
Phone (818) 545-9539

222 W Eulalia St
Ste 100A
Glendale, CA 91204
Phone (818) 244-8161

1030 S Glendale Ave
Ste 304
Glendale, CA 91205
Phone (818) 291-4041

222 W Eulalia St
Ste 315
Glendale, CA 91204
Phone (818) 240-2242

1500 S Central Ave
Ste 318
Glendale, CA 91204
Phone (818) 548-5437

2880 Atlantic Ave
Ste 290
Long Beach, CA 90806
Phone (562) 534-1777

8631 W 3rd St
Ste 540
Los Angeles, CA 90048
Phone (424) 999-5677

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Robert M Bonner Individual Corporate OfficerTreasurer Oct 25, 2021
W-2 Managing Employee Oct 25, 2021
Melody L Gabriel Individual Corporate DirectorBoard Member Jun 1, 2015
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 15, 2015
James E Pedersen Individual Corporate DirectorBoard Member Jan 16, 2017
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Ricardo B Graham Individual Corporate DirectorBoard Member Dec 17, 2007
Alice H Issai Individual Corporate OfficerPresident Jul 2, 2018
W-2 Managing EmployeePresident Jul 2, 2018
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Billy D Wing Individual Corporate OfficerVice Chair/Assistant Secretary Mar 31, 2014
Corporate DirectorVice Chair/Assistant Secretary Mar 31, 2014
Wesley E Rippey Individual Corporate DirectorBoard Member Sep 14, 1998
David P Banks Individual Corporate DirectorBoard Member May 5, 2017
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jack W Wagner Individual Corporate OfficerAsst Secretary Mar 31, 2014
Brian S Reiner Individual Corporate OfficerChairman of the Board Mar 31, 2014
Corporate DirectorChairman of the Board Mar 31, 2014
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Non-profit 5% Or Greater Direct Ownership Interest Jun 16, 1980 100%
Operational/Managerial Control Jun 16, 1980 100%
Warren Tetz Individual Corporate OfficerAssisant Secretary Sep 14, 1999
W-2 Managing EmployeeSr VP Operations/Coo Sep 14, 1999

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 105

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

View all 105

Practitioners & affiliated clinicians

Practitioners 504

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

View all 504

Affiliated clinicians 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1114916293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "818-546-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "818-546-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE ADVENTIST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "ISSAI",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-409-8289"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "930000059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55419F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1509 Wilson Ter",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912064007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adventist Health Glendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.