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Providence Saint John'S Health Center

Organization Active NPI General Acute Care Hospital · Santa Monica, CA

NPI 1124026273 · NPPES record last updated May 9, 2025

Key facts

NPI
1124026273
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
930000158 (CA)
Legal business name
PROVIDENCE SAINT JOHN'S HEALTH CENTER
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone
(310) 829-5511
Fax
(310) 315-6135
NPI assigned
Jul 12, 2005
Organization subpart
No

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary Enrollments
Phone
(425) 358-9786

Owners & managing parties with NPI records 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

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

Facilities with the same owner 140

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

View all 140

Practitioners 415

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

View all 415

Affiliated clinicians 681

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

View all 681

Medicare Care Compare: Hospital

Listed as
Saint John'S Health Center CCN 050290
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0550281Providence Saint John'S Health Center/
2121 Santa Monica Blvd, Santa Monica, CA 90404		AccreditationApr 11, 2027
05D1065760Providence Saint John'S Health Center
2121 Santa Monica Blvd, Santa Monica, CA 90404		Provider-performed microscopyMar 7, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Hospital certification: CCN 050290

Legal name
PROVIDENCE SAINT JOHNS HEALTH CENTER
Doing business as
SAINT JOHN'S HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 30, 2023
Beds
317
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Apr 13, 1940 in CA
Enrollment address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Diane L Hejna
Individual 		Corporate Director
Director		 Jul 1, 2016
Richard S Blair
Individual 		Corporate Director
Director		 Jul 1, 2016
Marvin O'Quinn
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Linda Buck
Individual 		Corporate Director
Director		 Jan 1, 2025
Jason Kell
Individual 		W-2 Managing Employee
Financial Executive		 Jan 1, 2026
Providence Health & Services - Washington
Organization · Renton, WA
Non-profit 		Operational/Managerial Control Mar 1, 2014
Mary E Lyons
Individual 		Corporate Director
Director		 Jul 1, 2016
Michael Ricks
Individual 		W-2 Managing Employee
Chief Executive, Ca Region		 Sep 30, 2019
Providence Health System Southern California
Organization · Renton, WA
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Mar 1, 2014 100%
Phyllis M Hughes
Individual 		Corporate Director Mar 1, 2014
Rogelio Riojas
Individual 		Corporate Director
Director		 Jan 1, 2025
James Martin
Individual 		Corporate Officer
Authorized Official		 Jan 13, 2023
Charles Wallace Sorenson
Individual 		Corporate Director
Board of Directors		 Jan 1, 2019
Donald Wayne Anderson
Individual 		Corporate Officer
Assistant Secretary for Enrollment		 Dec 20, 2016
Gregory David Hoffman
Individual 		Corporate Officer
President/Ceo & Treasurer		 Oct 1, 2020
Isiaah D Crawford
Individual 		Corporate Director Mar 1, 2014
Donna Markham
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Michael W Murphy
Individual 		Corporate Director
Director		 Jan 1, 2020
Providence Health & Services
Organization · Renton, WA
Corporation, Non-profit 		Other Jul 1, 2016
Mary Beth Kingston
Individual 		Corporate Director
Board Member		 Sep 1, 2022
Eric D Sprunk
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Anna R Newsom
Individual 		Corporate Officer
Corporate Secretary		 May 13, 2022
Darryl Elmouchi
Individual 		Corporate Officer
President/Ceo		 Apr 1, 2025
Karin Dufault
Individual 		Corporate Director
Director		 Jan 1, 2025
Providence St. Joseph Health
Organization · Renton, WA
Corporation, Non-profit 		Other Jul 1, 2016

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041214001254 CA Part B Supplier - Clinic/Group Practice 4183681810 Receives reassigned benefits from 6 practitioners
Practice locations: Santa Monica, CA
O20071219000288 CA Part a Provider - Hospital 4183681810 Practice locations: Santa Monica, CA

National Provider Directory

Locations (25 of 28)

726 E Main St
Alhambra, CA 91801
Phone (213) 808-1700

201 S Buena Vista St
#410420
Burbank, CA 91505

45280 Seeley Dr
La Quinta, CA 92253
Phone (760) 834-3593

1213 E Ocean Ave
Lompoc, CA 93436
Phone (805) 736-8628

8631 W 3rd St
Ste 810E
Los Angeles, CA 90048
Phone (310) 652-3570

11965 Venice Blvd
Ste 300
Los Angeles, CA 90066
Phone (310) 562-0441

1245 Wilshire Blvd
Ste 775
Los Angeles, CA 90017
Phone (213) 484-5397

8631 W 3rd St
Ste 1115E
Los Angeles, CA 90048
Phone (310) 278-8330

1901 Outlet Center Dr
Ste 260
Oxnard, CA 93036
Phone (805) 604-1824

2001 Santa Monica Blvd
Ste 670W
Santa Monica, CA 90404
Phone (310) 828-3001

2021 Santa Monica Blvd
Ste 245E
Santa Monica, CA 90404
Phone (310) 829-4403

2001 Santa Monica Blvd
Ste 495W
Santa Monica, CA 90404
Phone (310) 829-3636

1304 15th St
Ste 100
Santa Monica, CA 90404
Phone (310) 393-4655

1811 Wilshire Blvd
Ste 110
Santa Monica, CA 90403
Phone (310) 453-9010

1301 20th St
Ste 360
Santa Monica, CA 90404
Phone (310) 453-7856

1831 Wilshire Blvd
Ste B
Santa Monica, CA 90403
Phone (310) 400-5565

2216 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 264-2100

2020 Santa Monica Blvd
Ste 401
Santa Monica, CA 90404
Phone (310) 573-8866

2021 Santa Monica Blvd
Ste 510E
Santa Monica, CA 90404
Phone (310) 828-8531

2042 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 829-5511

2001 Santa Monica Blvd
Ste 180W
Santa Monica, CA 90404
Phone (310) 829-0277

2021 Santa Monica Blvd
Ste 102
Santa Monica, CA 90404
Phone (310) 829-5511

2001 Santa Monica Blvd
Ste 1265W
Santa Monica, CA 90404
Phone (310) 828-8566

2021 Santa Monica Blvd
Ste 300E
Santa Monica, CA 90404
Phone (310) 264-7314

18372 Clark St
Ste 226
Tarzana, CA 91356
Phone (818) 881-9192

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 930000158 CA Yes

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Mailing address

1328 22ND St
Santa Monica, CA 90404-2032
Phone (310) 829-5511

Other identifiers

IdentifierTypeStateIssuer
ZZT30290FMedicaidCA
ZZT40290FMedicaidCA

Other providers in Santa Monica, CA

All providers in Santa Monica, CA · General Acute Care Hospital in California

Sources for this page

Verify at the official NPI Registry.