NPIMap

Organization Active NPI

Sutter Valley Hospitals

Doing business as Memorial Hospital Los Banos

  • General Acute Care Hospital
  • Los Banos, CA
National Provider Identifier
1366896300
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
SUTTER VALLEY HOSPITALS
Doing business as
Memorial Hospital Los Banos
Practice address
520 W I St
Los Banos, CA 93635-3419
Phone
(209) 826-0591
Fax
(209) 826-1943
NPI assigned
Apr 15, 2016
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Paige A. Terra
Title
Cfo
Phone
(916) 887-7050

Specialties & licenses 1

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

Addresses

Primary practice location

520 W I St
Los Banos, CA 93635-3419

Mailing address

2700 Gateway Oaks Dr
Suite 2200
Sacramento, CA 95833-4337
Phone (916) 887-7040

Other names 1

  • Memorial Hospital Los Banos Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170209001760 CA Part A Provider - Hospital 3375531635 Practice locations: Los Banos, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366896300. Details of each certification follow.

Hospital certification: CCN 050528

Legal name
SUTTER VALLEY HOSPITALS
Doing business as
MEMORIAL HOSPITAL LOS BANOS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 5, 1967
Last certification
Apr 26, 2013
Beds
48
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 24, 1935 in CA
Enrollment address
520 W I St
Los Banos, CA 93635-3419
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Hospital Los BanosCCN 050528 · All quality measures
Overall star rating
3 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
Tax ID family
Sutter Community Hospit27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Member organizations 5

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Ann Marszal Individual Corporate DirectorBoard Member Jan 1, 2025
Rishi a Menon Individual Corporate DirectorBoard Member Jan 1, 2025
Ronnie Yamanaka Individual Corporate OfficerCfo Jan 4, 2024
W-2 Managing Employee Jan 4, 2024
John Reynen Individual Corporate DirectorBoard Member Jan 1, 2025
David Warter Individual Corporate DirectorBoard Member Jan 1, 2025
Todd C Smith Individual Corporate DirectorBoard Member May 21, 2015
Daniel Flores Individual Corporate DirectorBoard Member Sep 1, 2018
Benjamin Duran Individual Corporate DirectorBoard Member Jan 1, 2025
Raeleigh Payanes Individual Corporate DirectorBoard Member Jan 1, 2025
Dineen Johnson Greer Individual Corporate DirectorBoard Member Jan 1, 2025
Bronwyn Fields Individual Corporate DirectorBoard Member Sep 1, 2018
Maria G Pallavicini Individual Corporate DirectorBoard Member Aug 3, 2017
Chrysanthy Demos Individual Corporate DirectorBoard Member Jan 1, 2025
Jerry Tokunaga Individual Corporate DirectorBoard Member Sep 1, 2018
Hien Son Le Individual Corporate DirectorBoard Member Jan 1, 2025
Sutter Health Organization, Sacramento, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 1, 1996 100%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Sutter Auburn Faith HospitalAuburn, CA, CCN 050498 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 1996
Sutter Solano Medical CenterVallejo, CA, CCN 050101 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2009
Sutter Amador HospitalJackson, CA, CCN 050014 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2009
Memorial Medical CenterModesto, CA, CCN 050557 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2017
Sutter Surgical Hospital-North ValleyYuba City, CA, CCN 050766 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 12, 2026
Memorial Hospital Los Banos Rural Health ClinicLos Banos, CA, CCN 553998 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 1, 2017

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 59

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

View all 59

Practitioners & affiliated clinicians

Affiliated clinicians 171

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

View all 171

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1366896300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GATEWAY OAKS DR",
            "address_2": "SUITE 2200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958334337",
            "telephone_number": "916-887-7040",
            "fax_number": "916-887-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353419",
            "telephone_number": "209-826-0591",
            "fax_number": "209-826-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER VALLEY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "TERRA",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-887-7050"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Hospital Los Banos",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hospital Los Banos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.