NPIMap

Organization Active NPI

Palo Verde Health Care District

Doing business as Palo Verde Hospital

  • General Acute Care Hospital
  • Blythe, CA
National Provider Identifier
1194705202
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
250000184 Issued in CA
Legal business name
PALO VERDE HEALTH CARE DISTRICT
Doing business as
Palo Verde Hospital
Practice address
250 N 1St St
Blythe, CA 92225-1702
Phone
(760) 922-4115
NPI assigned
Jan 17, 2006
Last updated
Nov 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Sandra J Anaya, RN
Title
Ceo
Phone
(760) 922-4115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 250000184 CA Primary

Addresses

Primary practice location

250 N 1St St
Blythe, CA 92225-1702

Mailing address

250 N 1St St
Blythe, CA 92225-1702

Other identifiers 3

IdentifierTypeStateIssuer
ZZT30423HMedicaidCA
ZZT40423HMedicaidCA
050423OtherCABLUE CROSS BLUE SHIELD

Other names 1

  • Palo Verde Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051214000926 CA Part B Supplier - Clinic/Group Practice 3678593712 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Blythe, CA
O20201120000408 CA Part A Provider - Critical Access Hospital 3678593712 Practice locations: Blythe, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194705202. Details of each certification follow.

Hospital certification: CCN 051339

Legal name
PALO VERDE HEALTH CARE DISTRICT
Doing business as
PALO VERDE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 20, 2023
Last certification
Jul 20, 2023
Beds
51
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
250 N 1St St
Blythe, CA 92225-1702
Main/Primary Hospital Location

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Palo Verde HospitalCCN 051339 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
David Brooks Individual Corporate DirectorBoard Member Jan 1, 2015
Samuel a Burton Individual Corporate DirectorDirector Dec 3, 2010
Palo Verde Health Care District Organization, Blythe, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jun 3, 2005 100%
Sandra J Anaya Individual Corporate OfficerCeo Sep 5, 2013
Christa a Rohde Individual W-2 Managing EmployeeCfo Sep 5, 2013
Carmela F Garnica Individual Corporate DirectorBoard Member Dec 4, 2018
Rosalie Rowell Individual Corporate DirectorBoard Member Dec 4, 2018
William Van Noll Individual Corporate OfficerCfo Sep 1, 2023
Trina R Sartin Individual Corporate DirectorBoard Member Dec 7, 2012

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1194705202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N 1ST ST",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N 1ST ST",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "922251702",
            "telephone_number": "760-922-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO VERDE HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "ANAYA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-922-4115",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "250000184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30423H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40423H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "050423",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palo Verde Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blythe, CA

Sources for this page

Verify at the official NPI Registry.