NPIMap

Organization Active NPI

Palomar Health

Doing business as Palomar Medical Center Poway

  • General Acute Care Hospital
  • Poway, CA
National Provider Identifier
1376513754
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PALOMAR HEALTH
Doing business as
Palomar Medical Center Poway
Practice address
15615 Pomerado Road
Poway, CA 92064
Phone
(858) 613-4000
Fax
(442) 281-3745
NPI assigned
Jan 26, 2006
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PALOMAR HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Diane Hansen
Title
President and Ceo
Phone
(760) 740-6385

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X 080000127 CA
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

15615 Pomerado Road
Poway, CA 92064

Mailing address

2125 Citracado Pkwy Ste 300
Escondido, CA 92029-4159

Other identifiers 4

IdentifierTypeStateIssuer
ZZT40636FMedicaidCA
19469OtherCA3D MAMMOGRAPH DHCS
HSC30636FMedicaidCA
ZZT30636FMedicaidCA

Other names 1

  • Palomar Medical Center Poway Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110323000080 CA Part A Provider - Hospital 0840325767 Practice locations: Poway, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376513754. Details of each certification follow.

Hospital certification: CCN 050636

Legal name
PALOMAR HEALTH
Doing business as
PALOMAR MEDICAL CENTER POWAY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 22, 1977
Last certification
Nov 14, 2019
Beds
236 (95 certified)
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Incorporated
Jun 24, 1948 in CA
Enrollment address
15615 Pomerado Rd
Poway, CA 92064-2405
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Long-term

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Palomar Medical Center PowayCCN 050636 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Pomerado Hospital Phcy

Locations

120 Craven Rd
Ste 200
San Marcos, CA 92078

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Palomar Health Organization, Escondido, CA Operational/Managerial Control Jan 1, 1966 100%
Diane Hansen Individual Corporate OfficerPresident & Ceo Dec 1, 2017 100%
Corporate DirectorPresident & Ceo Dec 1, 2017
W-2 Managing EmployeePresident & Ceo Oct 15, 2012
Jami L Piearson Individual Corporate DirectorDirector Regulatory Feb 4, 2019
W-2 Managing EmployeeDirector Regulatory Feb 4, 2019
Helen S Waishkey Individual Corporate OfficerCorporate Compliance Officer Aug 30, 2021
Corporate DirectorCorporate Compliance Officer Aug 30, 2021
W-2 Managing EmployeeCorporate Compliance Officer Aug 30, 2021

Owners & managing parties with NPI records 2

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

  • Palomar Health

    dba Palomar Medical Center Escondido

    • General Acute Care Hospital
    • Escondido, CA
    • NPI 1457321317

    Operational/Managerial Control

    CMS ownership
  • Palomar Health

    dba The Villas at Poway

    • Skilled Nursing Facility
    • Poway, CA
    • NPI 1619947090

    Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Palomar Medical Center EscondidoEscondido, CA, CCN 050115 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Palomar Rehabilitation InstituteEscondido, CA, CCN 053043 Hospital 5% Or Greater Direct Ownership Interest (49%) Apr 27, 2021
The Villas at PowayPoway, CA, CCN 555301 Skilled nursing facility Operational/Managerial Control (100%) Jun 24, 1966

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 368

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

View all 368

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1376513754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CITRACADO PKWY STE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294159",
            "fax_number": "760-740-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 POMERADO ROAD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-613-4000",
            "fax_number": "442-281-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOMAR HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALOMAR HEALTH",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "760-740-6385"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "080000127",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40636F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "3D MAMMOGRAPH DHCS",
            "identifier": "19469",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30636F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30636F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palomar Medical Center Poway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.