NPIMap

Organization Active NPI

Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
National Provider Identifier
1124026273
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
930000158 Issued in 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
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

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

Specialties & licenses 1

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

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

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124026273. Details of each certification follow.

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
CorporationNon-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

Care Compare: Hospital

Medicare Care Compare
Listed as
Saint John's Health CenterCCN 050290 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown 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 90404AccreditationApr 11, 2027
05D1065760Providence Saint John's Health Center2121 Santa Monica Blvd, Santa Monica, CA 90404Provider-performed microscopyMar 7, 2027

National Provider Directory

National Provider Directory

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.

Locations (25 of 27)

3831 Hughes Ave
Ste 104
Culver City, CA 90232
Phone (310) 837-9700

10800 Paramount Blvd
Ste 401
Downey, CA 90241
Phone (562) 869-2503

736 E Grand Ave
Escondido, CA 92025
Phone (615) 851-0144

1213 E Ocean Ave
Lompoc, CA 93436
Phone (805) 737-3300

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

1990 Westwood Blvd
Ste 238
Los Angeles, CA 90025
Phone (310) 393-7147

23805 Stuart Ranch Rd
Ste 210
Malibu, CA 90265
Phone (310) 456-1725

1100 N Ventura Rd
Ste 101
Oxnard, CA 93030
Phone (805) 214-1514

4860 Y St
Ste 2200
Sacramento, CA 95817
Phone (916) 734-2222

1301 20th St
Ste 105
Santa Monica, CA 90404
Phone (310) 828-2352

1301 20th St
Ste 270
Santa Monica, CA 90404
Phone (310) 828-8585

1301 20th St
Ste 465
Santa Monica, CA 90404
Phone (310) 749-1516

1339 20th St
Santa Monica, CA 90404
Phone (310) 829-8708

1821 Wilshire Blvd
Ste 100
Santa Monica, CA 90403
Phone (310) 575-3100

2001 Santa Monica Blvd
#760
Santa Monica, CA 90404
Phone (310) 582-7474

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

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

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

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

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

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

901 Wilshire Blvd
Fl 3
Santa Monica, CA 90401
Phone (310) 829-8903

13303 Riverside Dr
Sherman Oaks, CA 91423
Phone (818) 287-7409

5215 Torrance Blvd
#300
Torrance, CA 90503

15243 Vanowen St
Ste 504
Van Nuys, CA 91405
Phone (818) 785-3889

Ownership & related parties

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 DirectorDirector Jul 1, 2016
Richard S Blair Individual Corporate DirectorDirector Jul 1, 2016
Marvin O'Quinn Individual Corporate DirectorBoard Member Jan 1, 2024
Linda Buck Individual Corporate DirectorDirector Jan 1, 2025
Jason Kell Individual W-2 Managing EmployeeFinancial Executive Jan 1, 2026
Providence Health & Services - Washington Organization, Renton, WA Non-profit Operational/Managerial Control Mar 1, 2014
Mary E Lyons Individual Corporate DirectorDirector Jul 1, 2016
Michael Ricks Individual W-2 Managing EmployeeChief 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 DirectorDirector Jan 1, 2025
James Martin Individual Corporate OfficerAuthorized Official Jan 13, 2023
Charles Wallace Sorenson Individual Corporate DirectorBoard of Directors Jan 1, 2019
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary for Enrollment Dec 20, 2016
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
Isiaah D Crawford Individual Corporate Director Mar 1, 2014
Donna Markham Individual Corporate DirectorBoard Member Jan 1, 2024
Michael W Murphy Individual Corporate DirectorDirector Jan 1, 2020
Providence Health & Services Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016
Mary Beth Kingston Individual Corporate DirectorBoard Member Sep 1, 2022
Eric D Sprunk Individual Corporate DirectorBoard Member Jan 1, 2022
Anna R Newsom Individual Corporate OfficerCorporate Secretary May 13, 2022
Darryl Elmouchi Individual Corporate OfficerPresident/Ceo Apr 1, 2025
Karin Dufault Individual Corporate DirectorDirector Jan 1, 2025
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016

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 140

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

View all 140

Practitioners & affiliated clinicians

Practitioners 415

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 415

Affiliated clinicians 681

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

View all 681

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1124026273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 22ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042032",
            "telephone_number": "310-829-5511",
            "fax_number": "310-315-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-829-5511",
            "fax_number": "310-315-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SAINT JOHN'S HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "930000158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.