NPIMap

Organization Active NPI

Mission Hospital, Inc.

  • General Acute Care Hospital
  • Mission, TX
National Provider Identifier
1205833985
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
000370 Issued in TX
Legal business name
MISSION HOSPITAL, INC.
Practice address
900 S Bryan Rd
Mission, TX 78572-6613
Phone
(956) 323-9102
Fax
(956) 323-1817
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Lester Surrock, CPA
Title
Cfo
Phone
(956) 323-9106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
General Acute Care Hospital 282N00000X 000370 TX Primary

Addresses

Primary practice location

900 S Bryan Rd
Mission, TX 78572-6613

Mailing address

900 S Bryan Rd
Mission, TX 78572-6613
Phone (956) 323-9102

Other identifiers 2

IdentifierTypeStateIssuer
1126799-01MedicaidTX
1126799-02MedicaidTX

Other names 1

  • MISSION REGIONAL MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050509000397 TX Part A Provider - Hospital 0042270563 1 other NPI on this enrollment
Practice locations: Mission, TX

Hospital certification: CCN 450176

Legal name
MISSION HOSPITAL INC
Doing business as
MISSION REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 20, 2024
Beds
297
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 28, 1981 in TX
Enrollment address
900 S Bryan Rd
Mission, TX 78572-6613
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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
Mission Regional Medical CenterCCN 450176
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

National Provider Directory

National Provider Directory

Member of 1

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

Member organizations 1

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

Locations

18 Endeavor
Ste 208
Irvine, CA 92618
Phone (949) 276-4008

900 S Bryan Rd
#5
Mission, TX 78572
Phone (956) 323-9500

Ownership & related parties

All disclosed owners & managing parties 12

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 Other Jul 1, 2017
Alicia Requenez Individual Corporate Director Jul 1, 2017
Prime Healthcare Foundation - Mission LLC Organization, Ontario, CA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2017 100%
Kane Dawson Individual Corporate DirectorChief Executive Officer Jul 1, 2017
Estella Saenz Individual Corporate Director Jul 1, 2017
Lester E Surrock Individual Corporate OfficerChief Financial Officer Jan 4, 2018
W-2 Managing EmployeeChief Financial Officer Jan 4, 2018
Cesar Guerra Individual Corporate OfficerChief Nursing Officer Jul 5, 2021
W-2 Managing EmployeeChief Nursing Officer Jul 5, 2021
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Jul 1, 2017
W-2 Managing EmployeeChief Compliance Counsel Jul 1, 2017
Padmini Bhadriraju Individual Corporate OfficerChief Medical Officer Dec 1, 2020
Corporate DirectorDirector Dec 1, 2020
Elizabeth Garza Individual Corporate Director Feb 24, 2009
Prime Healthcare Foundation Inc Organization, Ontario, CA Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2017
Deborah Cordova Individual Corporate DirectorBoard Member Jul 1, 2017

Owners & managing parties with NPI records 2

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

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 50

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

View all 50

Affiliated clinicians 145

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

View all 145

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1205833985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9102",
            "fax_number": "956-323-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9102",
            "fax_number": "956-323-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "SURROCK",
        "authorized_official_first_name": "LESTER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "956-323-9106",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "000370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126799-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126799-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSION REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MISSION REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.