Stanford Health Care

Organization Active NPI General Acute Care Hospital · Emeryville, CA

NPI 1285177337 · NPPES record last updated Mar 7, 2017

Key facts

NPI
1285177337
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
070000662 (CA)
Legal business name
STANFORD HEALTH CARE
Practice address
6121 Hollis St
Emeryville, CA 94608-2077
Phone
(650) 498-5785
NPI assigned
Nov 22, 2016
Organization subpart
No

Authorized official

Name
Larue Perkins
Title
Senior Manager
Phone
(650) 498-5785

Owners & managing parties with NPI records 8

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

Other NPIs on the same Medicare enrollment 6

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

Member organizations 3

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

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

Affiliated clinicians 3,901

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

View all 3,901

Medicare Care Compare: Hospital

Listed as
Stanford Health Care CCN 050441
Overall star rating
★★★★★ 5 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.

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
Stanford Hospital & Clinics CCN 05T441
Ownership
Non-profit
Certified
Sep 1, 1992

Source: Medicare Care Compare. This is a unit of this hospital with its own CMS Certification Number; Care Compare reports it separately, and it has no NPI of its own (how units are connected).

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Hospital certification: CCN 050441

Legal name
STANFORD HEALTH CARE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1968
Last certification
Jul 25, 2025
Beds
613
Ownership / control type
Private (not for profit)
Most recent change of ownership
Apr 1, 2000 (1 total)
Organization structure
Corporation · Non-profit
Incorporated
Apr 12, 1957 in CA
Enrollment address
300 Pasteur Dr
Stanford, CA 94305-2200
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit, Rehabilitation unit, Other

All disclosed owners & managing parties 35

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

NameRoleSinceShare
Lloyd Brooks Minor
Individual
Corporate Director
Board Member
Dec 1, 2012
Mindy Rogers
Individual
Corporate Officer
Board Member Vice Chair
Nov 1, 2018
Eila C Skinner
Individual
Corporate Officer
Board Member
Jan 1, 2023
Rachelle Nolan
Individual
W-2 Managing Employee
Provider Enrollment Coor
Oct 12, 2015
Lata Krishnan
Individual
Corporate Officer
Board Member
Apr 1, 2018
Gurinder Sarao
Individual
W-2 Managing Employee
Credentialing Assistant
Sep 1, 2017
Amit Sinha
Individual
Corporate Officer
Board Member
Apr 1, 2023
Jill Buathier
Individual
W-2 Managing Employee
Chief Revenue Cycle Officer
Feb 28, 2013
Operational/Managerial Control
Chief Revenue Cycle Officer
Feb 28, 2013
Hamid R Moghadam
Individual
Corporate Officer
Board Member
Sep 1, 2021
Kavitark R Shriram
Individual
Corporate Officer
Board Member
Sep 1, 2019
The Board of Trustees of the Leland Stanford Junior University
Organization · Stanford, CA
Corporation
Other Jul 1, 1968
Naira Guerrero
Individual
W-2 Managing Employee
Credentialing Assistant
Nov 18, 2018
Robert T Santos
Individual
Corporate Officer
Board Member
Jan 1, 2021
Hanh Truong
Individual
W-2 Managing Employee
Provider Enrollment Coor
Nov 16, 2020
Jeffrey J Rothschild
Individual
Corporate Officer
Board Member
Jan 1, 2021
Mark Leslie
Individual
Corporate Officer
Board Member
Sep 1, 2015
Paul King
Individual
Corporate Officer
Board Member
Jan 28, 2019
Karen Jordan
Individual
Corporate Officer
Board Member
Jan 1, 2023
Susan Bechtel
Individual
Corporate Officer
Board Member
Nov 1, 2015
Stanford Health Care
Organization · Stanford, CA
Non-profit
5% Or Greater Direct Ownership Interest Feb 27, 2013 100%
Thomas Jude Montine
Individual
Corporate Officer
Board Member
Jan 1, 2022
Randall Livingston
Individual
Corporate Officer
University Liaison for Stanford
Jan 1, 2019
Sara Abbasu
Individual
Corporate Officer
Board Member
May 1, 2021
Mariann Byerwalter
Individual
Corporate Officer
Board Member
Apr 1, 2000
David Entwistle
Individual
Corporate Officer
President & Ceo
Jul 5, 2016
W-2 Managing Employee
President & Ceo
Jul 5, 2016
Kaye Foster
Individual
Corporate Officer
Board Member
Nov 1, 2014
Cecilia Herbert
Individual
Corporate Officer
Board Member
Sep 1, 2016
Cynthia Gulick
Individual
Corporate Director
Director, MSS & Credentialing
Sep 7, 2021
W-2 Managing Employee Sep 7, 2021
William Brody
Individual
Corporate Officer
Board Member
Nov 1, 2015
Jay Bakul Shah
Individual
Corporate Officer
Board Member
Sep 1, 2022
Lisa M Sangam
Individual
W-2 Managing Employee
Manager of MSSD
Sep 7, 2021
Jeffrey W Bird
Individual
Corporate Officer
Board Member
Jan 1, 2022
Gladys Rufo
Individual
W-2 Managing Employee
Provider Enrollment Coor
Nov 7, 2016
Marc Jones
Individual
Corporate Officer
Board Member Chair
Jan 1, 2020
Jonathan Jay Coslet
Individual
Corporate Officer
Board Member
Jan 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030731000003 CA Part a Provider - Hospital 6709797491 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Jose, CA; Los Altos, CA; Stanford, CA; Palo Alto, CA; Emeryville, CA; Pleasanton, CA; Los Gatos, CA; Redwood City, CA…

National Provider Directory

Locations

6121 Hollis St
Emeryville, CA 94608
Phone (510) 266-5400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 070000662 CA Yes

Addresses

Primary practice location

6121 Hollis St
Emeryville, CA 94608-2077

Mailing address

6121 Hollis St
Emeryville, CA 94608-2077

Other names

  • Stanford Health Care Emeryville 6121 Doing business as

Other providers in Emeryville, CA

All providers in Emeryville, CA · General Acute Care Hospital in California

Sources for this page

Verify at the official NPI Registry.