NPIMap

Organization Active NPI

Sutter Bay Hospitals

  • Medicare Defined Swing Bed Hospital Unit
  • Lakeport, CA
National Provider Identifier
1598098642
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
110000094 Issued in CA
Legal business name
SUTTER BAY HOSPITALS
Practice address
5176 Hill Rd E
Lakeport, CA 95453-6300
Phone
(707) 262-5000
Fax
(707) 262-5003
NPI assigned
Sep 8, 2009
Last updated
Jan 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
John B. Gates
Title
Cfo
Phone
(510) 450-7357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 110000094 CA Primary

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453-6300

Mailing address

PO Box 742412
Los Angeles, CA 90074-2412
Phone (415) 600-7120

Other identifiers 1

IdentifierTypeStateIssuer
LTC 30476FMedicaidCA

Other names 1

  • Sutter West Bay Hospitals Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091029000470 CA Part A Provider - Critical Access Hospital 3476506528 Practice locations: Lakeport, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598098642. Details of each certification follow.

Hospital certification: CCN 05Z329

Legal name
SUTTER BAY HOSPITALS
Doing business as
SUTTER LAKESIDE HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Dec 9, 1885 in CA
Enrollment address
5176 Hill Rd E
Lakeport, CA 95453-6300

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

Other NPIs with the same Medicare PAC ID 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Childrens Hosp Pharmacy62 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.

View all 24

Locations

7777 Greenback Ln
Ste 103
Citrus Hts, CA 95610
Phone (916) 835-7777

14440 Olympic Dr
Clearlake, CA 95422
Phone (707) 263-8382

5685 Main St
Kelseyville, CA 95451
Phone (707) 279-8733

5196 Hill Rd E
Ste 201
Lakeport, CA 95453
Phone (707) 263-4108

987 Parallel Dr
Lakeport, CA 95453
Phone (707) 262-5088

987 Parallel Dr
Ste C
Lakeport, CA 95453
Phone (707) 262-5000

1000 Trancas St
Ste 1
Napa, CA 94558
Phone (707) 253-7161

350 Hawthorne Ave
Ste 2308
Oakland, CA 94609
Phone (510) 869-6883

6000 State Farm Dr
Ste 150
Rohnert Park, CA 94928
Phone (707) 559-7600

1101 Van Ness Ave
#3
San Francisco, CA 94109
Phone (415) 600-8751

Ownership & related parties

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.

NameRoleSinceShare
Yvonne Richardson Individual Corporate DirectorBoard Member Aug 4, 2021
Todd C Smith Individual Corporate DirectorBoard Member Jun 12, 2023
Gregory Brown Individual Corporate DirectorBoard Member Jan 1, 2025
Jill M Kacher Cobb Individual Corporate DirectorBoard Member Jan 1, 2019
Arnold Schaffer Individual Corporate DirectorBoard Member Jan 1, 2024
Theodore Deikel Individual Corporate DirectorBoard Member Jan 1, 2010
Janet Garufis Individual Corporate DirectorBoard Member Jan 1, 2024
Rita Ophelia Kwan-Feinberg Individual Corporate DirectorBoard Member Jan 1, 2025
Susan McCabe Individual Corporate DirectorSenior Director Jul 14, 2025
Juli Maxworthy Individual Corporate DirectorBoard Member Aug 4, 2021
Henry Yu Individual Corporate OfficerCfo Jun 9, 2023
W-2 Managing Employee Jun 9, 2023
Heidi J Schmidt Individual Corporate DirectorBoard Member Jan 1, 2025
Thomas Briody Individual Corporate DirectorBoard Member Feb 8, 2023
William L Brunetti Individual Corporate DirectorBoard Member Feb 8, 2023
Jeffrey T Strawn Individual Corporate DirectorBoard Member Jan 1, 2025
Yumi Nakagawa Individual Corporate DirectorBoard Member Jan 1, 2021
Sutter Health Organization, Sacramento, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2010
Aditi H Patel Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Sutter Lakeside HospitalLakeport, CA, CCN 051329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2010
California Pacific Medical Center - Davies CampusSan Francisco, CA, CCN 056245 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016

Owned or controlled facilities with NPI records 2

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

Practitioners 101

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.

View all 101

Affiliated clinicians 1

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": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1598098642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742412",
            "telephone_number": "415-600-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-262-5000",
            "fax_number": "707-262-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER BAY HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "510-450-7357"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "CA",
            "license": "110000094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC 30476F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter West Bay Hospitals",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Sutter West Bay Hospitals",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.