NPIMap

Organization Active NPI

Goldfield Mountain Healthcare LLC

Doing business as Alta Mesa Health and Rehabilitation

  • Skilled Nursing Facility
  • Mesa, AZ
National Provider Identifier
1326505041
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GOLDFIELD MOUNTAIN HEALTHCARE LLC
Doing business as
Alta Mesa Health and Rehabilitation
Practice address
5848 E University Dr
Mesa, AZ 85205-7443
Phone
(408) 981-0098
Fax
(480) 396-3023
NPI assigned
Feb 28, 2019
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Soon Burnam
Title
Authorized Official
Phone
(949) 487-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

5848 E University Dr
Mesa, AZ 85205-7443

Mailing address

5848 E University Dr
Mesa, AZ 85205-7443
Phone (408) 981-0098

Other names 1

  • Alta Mesa Health and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190509001624 AZ Part A Provider - Skilled Nursing Facility 6709129901 Practice locations: Mesa, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326505041. Details of each certification follow.

Skilled nursing facility certification: CCN 035171

Legal name
GOLDFIELD MOUNTAIN HEALTHCARE LLC
Doing business as
ALTA MESA HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 2, 1988
Last certification
Nov 20, 2024
Beds
70
Ownership / control type
Corporation
Multi-facility organization
Bandera Healthcare INC
Organization structure
LLCProprietary
Incorporated
Feb 28, 2019 in NV
Enrollment address
5848 E University Dr
Mesa, AZ 85205-7443
Nursing home name
ALTA MESA HEALTH AND REHABILITATION
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Alta Mesa Health and RehabilitationCCN 035171 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 2, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7067.5 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Alta Mesa Health and Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Chandler Monks Individual Corporate OfficerPresident of Goldfield Mountain HC Mar 1, 2024
Organization, San Juan Capistrano, CA LLC Adp of the SNF Apr 9, 2025
Organization, San Juan Capistrano, CA Adp of the SNF Jan 1, 2022
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 28, 2019 100%
Adp of the SNF Jan 1, 2022
Forrest Peterson Individual Corporate OfficerSole Manager Apr 1, 2019
Ami Sato Individual Corporate OfficerTreasurer of Goldfield Mountain HC Sep 9, 2024
Bandera Healthcare LLC Organization, San Juan Capistrano, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 28, 2019 100%
Harish Nandipati Individual Operational/Managerial Control Nov 1, 2019
Managing Control - Governing BodyMedical Director Nov 1, 2019
Adp of the SNF Nov 1, 2019
Organization, San Juan Capistrano, CA LLC Adp of the SNF Jan 1, 2022
Bret C King Individual Operational/Managerial ControlAdministrator May 1, 2019
Managing Control - Governing BodyAdministrator May 1, 2019
Adp of the SNF May 1, 2019
Soon Burnam Individual Corporate OfficerSecretary of Goldfield Mountain HC Feb 28, 2019

Owners & managing parties with NPI records 1

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

  • Harish Nandipati, MD
    • Internal Medicine Physician
    • Mesa, AZ
    • NPI 1265662928

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1326505041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057443",
            "telephone_number": "408-981-0098",
            "fax_number": "480-396-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057443",
            "telephone_number": "408-981-0098",
            "fax_number": "480-396-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDFIELD MOUNTAIN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "949-487-9500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Alta Mesa Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.