NPIMap

Organization Active NPI

Mission Hospital, Inc

Doing business as Mission Regional Medical Center

  • Rehabilitation Hospital
  • Mission, TX
National Provider Identifier
1508895079
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
000370 Issued in TX
Legal business name
MISSION HOSPITAL, INC
Doing business as
Mission Regional Medical Center
Practice address
900 S Bryan Rd
Mission, TX 78572-6613
Phone
(956) 323-9000
NPI assigned
Jun 30, 2006
Last updated
May 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Authorized official

Name
Lester Edward Surrock
Title
Cfo
Phone
(956) 323-9106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 000370 TX Primary

Addresses

Primary practice location

900 S Bryan Rd
Mission, TX 78572-6613

Mailing address

900 S Bryan Rd
Mission, TX 78572-6613
Phone (956) 323-9000

Other names 1

  • Mission Regional Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050509000397 TX Part A Provider - Hospital 0042270563 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mission, TX
O20090217000055 TX Part A Provider - Hospital 0042270563 Practice locations: Mission, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1508895079. Details of each certification follow.

Hospital certification: CCN 450176

Legal name
MISSION HOSPITAL INC
Doing business as
MISSION REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 20, 2024
Beds
297
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 28, 1981 in TX
Enrollment address
900 S Bryan Rd
Mission, TX 78572-6613
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Hospital certification: CCN 45T176

Legal name
MISSION HOSPITAL INC
Doing business as
MISSION REGIONAL MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Sep 28, 1981 in TX
Enrollment address
900 S Bryan Rd
Mission, TX 78572-6613
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mission Regional Medical CenterCCN 450176 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Mission Regional Medical CenterCCN 45T176 · All quality measures
Ownership
Non-profit
Certified
Oct 1, 1998

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation Other Jul 1, 2017
Alicia Requenez Individual Corporate Director Jul 1, 2017
Corporate Director Feb 24, 2009
Prime Healthcare Foundation - Mission LLC Organization, Ontario, CA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2017 100%
Kane Dawson Individual Corporate DirectorChief Executive Officer Jul 1, 2017
Corporate OfficerCeo Jul 1, 2017
Corporate DirectorCeo Jul 1, 2017
W-2 Managing EmployeeCeo Jul 1, 2017
Estella Saenz Individual Corporate Director Jul 1, 2017
Lester E Surrock Individual Corporate OfficerChief Financial Officer Jan 4, 2018
W-2 Managing EmployeeChief Financial Officer Jan 4, 2018
Cesar Guerra Individual Corporate OfficerChief Nursing Officer Jul 5, 2021
W-2 Managing EmployeeChief Nursing Officer Jul 5, 2021
W-2 Managing EmployeeChief Nursing Officer Jan 1, 2021
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Jul 1, 2017
W-2 Managing EmployeeChief Compliance Counsel Jul 1, 2017
Corporate OfficerCheif Compliance Officer Jul 1, 2017
Padmini Bhadriraju Individual Corporate OfficerChief Medical Officer Dec 1, 2020
Corporate DirectorDirector Dec 1, 2020
Elizabeth Garza Individual Corporate Director Feb 24, 2009
Prime Healthcare Foundation Inc Organization, Ontario, CA Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2017
Deborah Cordova Individual Corporate DirectorBoard Member Jul 1, 2017
Corporate Director Jul 1, 2017

Owners & managing parties with NPI records 2

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

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Affiliated clinicians 145

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

View all 145

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1508895079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S BRYAN RD",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726613",
            "telephone_number": "956-323-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "SURROCK",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "956-323-9106"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "TX",
            "license": "000370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mission Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.