Kaiser Foundation Hospitals

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

930000079 Issued in CA

Legal business name

KAISER FOUNDATION HOSPITALS

Doing business as

Kaiser Foundation Hospital - South Bay

Practice address

25825 South Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 325-5111

NPI assigned

Jan 24, 2007

Last updated

Apr 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lesley A Wille

Title

Executive Director

Phone

(310) 517-2745

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Kaiser Foundation Hospital - South Bay Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336294040. Details of each certification follow.

• CCN 050411 Hospital · Active · Details

Hospital certification: CCN 050411

Legal name

KAISER FOUNDATION HOSPITALS

Doing business as

KAISER FOUNDATION HOSPITAL-SOUTH BAY

Certification status

Active

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Apr 27, 2018

Beds

251

Ownership / control type

Other

Organization structure

CorporationNon-profit

Incorporated

Feb 19, 1948 in CA

Enrollment address

25825 Vermont Ave
Harbor City, CA 90710-3518
Main/Primary Hospital Location

Hospital subgroups

Acute care

Listed as

Kaiser Foundation Hospital - South BayCCN 050411 · All quality measures

Overall star rating

3 of 5

Type

Acute Care Hospitals

Ownership

Voluntary non-profit - Other

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Tax ID family

Kaiser Foundation Hosp Phcy186 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Kaiser

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1295193209
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Permanente Pharmacy 985

  • Mail Order Pharmacy
  • Downey, CA
  • NPI 1265888630
  NPD tax ID
• Kaiser Foundation Hospitals

  • Community/Retail Pharmacy
  • Los Angeles, CA
  • NPI 1285781500
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kasier Foundation Hospital San Diego - Hospice

  • Community Based Hospice Care Agency
  • San Diego, CA
  • NPI 1285789099
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Home Health Martinez

  • Home Health Agency
  • Martinez, CA
  • NPI 1295800837
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Santa Clara ESRD

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Santa Clara, CA
  • NPI 1295809697
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital, Riverside

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1306991211
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Chem Dependency Recovery

  • Substance Abuse Rehabilitation Facility
  • Fontana, CA
  • NPI 1306991278
  NPD tax ID
• Kaiser Foundation Hospitals

  • Institutional Pharmacy
  • Baldwin Park, CA
  • NPI 1306994272
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Home Health Novato

  • Home Health Agency
  • Novato, CA
  • NPI 1316017213
  NPD tax ID
• Kaiser Foundation Hospitals

  • Institutional Pharmacy
  • Riverside, CA
  • NPI 1336296656
  NPD tax ID
• Kaiser Foundation Hospitals

  • Institutional Pharmacy
  • Downey, CA
  • NPI 1336376524
  NPD tax ID

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 1

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

• Regina M Benjamin, MD

  • Family Medicine Physician
  • Bayou la Batre, AL
  • NPI 1033188339

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 79

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facilities with the same owner 78

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Diego

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1013062769

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Hospice Program

  • Community Based Hospice Care Agency
  • West Covina, CA
  • NPI 1053466953

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Inland Empire Hospice

  • Community Based Hospice Care Agency
  • Fontana, CA
  • NPI 1053466961

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Hospice - Martinez

  • Community Based Hospice Care Agency
  • Martinez, CA
  • NPI 1053487793

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Mental Health Ctr DP AHP

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1063567956

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Jose

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063582989

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Roseville

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1073811378

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Fresno

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1083784672

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Home Health Santa Rosa

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1104996933

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Los Angeles HHA

  • Home Health Agency
  • Pasadena, CA
  • NPI 1124173059

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital West Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1134274897

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Francisco

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1134299522

  Kaiser Foundation Hospitals

  CMS ownership

Affiliated clinicians 297

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

• Peter S. Abdel Sayed, MD

  • Vascular & Interventional Radiology Physician
  • Anaheim, CA
  • NPI 1760553648

  Hospital

  Care Compare affiliation
• Elijah Abdelmeseeh

  • Hospitalist Physician
  • Long Beach, CA
  • NPI 1346827631
  Care Compare affiliation
• Rocco Addante, MD

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1215293014

  Hospital

  Care Compare affiliation
• Mehrdad Aghajani, NP

  • Family Nurse Practitioner
  • Santa Monica, CA
  • NPI 1588345334

  Hospital

  Care Compare affiliation
• Loreto Albaran, CRNA

  • Certified Registered Nurse Anesthetist
  • Harbor City, CA
  • NPI 1033310925

  Hospital

  Care Compare affiliation
• Hadi Ali, MD

  • Student in an Organized Health Care Education/Training Program
  • Bakersfield, CA
  • NPI 1164059044

  Hospital

  Care Compare affiliation
• Quincy Almond, M.D.

  • Hospitalist Physician
  • Orange, CA
  • NPI 1578573697
  Care Compare affiliation
• David R Alvarez, MD

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1255448924

  Hospital

  Care Compare affiliation
• Joel Amezquita, MD

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1558898437

  Hospital

  Care Compare affiliation
• Shaan Anand, MD

  • Nephrology Physician
  • Harbor City, CA
  • NPI 1417016015

  Hospital

  Care Compare affiliation
• Christopher Jason Angemi, D.O.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Torrance, CA
  • NPI 1386814671

  Hospital

  Care Compare affiliation
• Iman Mostapha Arafa, M.D.

  • Internal Medicine Physician
  • Harbor City, CA
  • NPI 1265967376

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1336294040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25825 SOUTH VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 SOUTH VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "WILLE",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-517-2745"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "930000079",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "930000079",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDOL",
            "identifier": "339040905",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30411F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS SECTION 1011",
            "identifier": "050411B000000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50411",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40411F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZC1971Z",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 South Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Foundation Hospital - South Bay",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Foundation Hospital - South Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wandy Q. Jung, PHARMD.
• Jennifer Kadah, LCSW
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Health Plan Inc
• Kaiser Foundation Hospitals
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permenente
• Edward Anthony Kalinowski, MD

• General Acute Care Hospital in Harbor City, CA
• Providers in Harbor City, CA by specialty
• General Acute Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.