Active NPI
Palomar Health
Doing business as The Villas at Poway
- Skilled Nursing Facility
- Poway, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 080000127
- Legal business name
- PALOMAR HEALTH
- Doing business as
- The Villas at Poway
Villa Pomerado - Practice address
- 15615 Pomerado Rd
Poway, CA 92064-2405 - Phone
- (858) 613-4545
- Fax
- (858) 675-5181
- NPI assigned
- Jan 26, 2006
- Last updated
- Jan 28, 2022
- Organization subpart
- Yes
- Parent organization
- PALOMAR HEALTH
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 080000127 | CA | Primary |
| Nursing Facility Supplies (DME) | 332BN1400X | 08000083 | CA | |
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 08000083 | CA |
Addresses
Primary practice location
15615 Pomerado Rd
Poway, CA 92064-2405
Mailing address
2125 Citracado Pkwy Ste 300
Escondido, CA 92029-4159
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC70151F | Medicaid | CA | |
| LTC55301F | Medicaid | CA |
Other names 2
- The Villas at Poway
- Villa Pomerado
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110107000299 | CA | Part A Provider - Skilled Nursing Facility | 0840325767 | Practice locations: Poway, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1619947090. Details of each certification follow.
Skilled nursing facility certification: CCN 555301
- Legal name
- PALOMAR HEALTH
- Doing business as
- THE VILLAS AT POWAY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 5, 1988
- Last certification
- Mar 23, 2023
- Beds
- 129
- Ownership / control type
- Hospital District
- Organization structure
- Other
- Incorporated
- Jun 24, 1948 in CA
- Enrollment address
- 15615 Pomerado Rd
Poway, CA 92064-2405 - Nursing home name
- THE VILLAS AT POWAY
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Palomar Medical Center Poway
- General Acute Care Hospital
- Poway, CA
- NPI 1376513754
0840325767
-
dba Palomar Medical Center Escondido
- General Acute Care Hospital
- Escondido, CA
- NPI 1457321317
0840325767
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Villas at Poway
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Certified
- May 5, 1988
- Medicare certification status
- Active
- Certified beds
- 129
- Penalties (3 years)
- 10
National Provider Directory
National Provider Directory- Tax ID family
- PPHS-Palomar
- Part of
- PPHS-Palomar
Other organizations with this tax ID 13
Organizations that report the same tax identification number in the National Provider Directory.
-
dba PMC Outpatient Pharmacy - Poway
- Community/Retail Pharmacy
- Poway, CA
- NPI 1073192720
-
dba Palomar Health Surgery Center
- Ambulatory Surgical Clinic/Center
- Escondido, CA
- NPI 1083065882
-
dba Palomar Health Expresscare
- Urgent Care Clinic/Center
- San Marcos, CA
- NPI 1093268369
-
dba Palomar Health Pharmacy Services - PMC Escondido
- Community/Retail Pharmacy
- Escondido, CA
- NPI 1245649904
-
dba Palomar Health Pharmacy Services - PMC Downtown Escondido
- Institutional Pharmacy
- Escondido, CA
- NPI 1285752063
-
dba Palomar Health Forensic Health Services
- Public Health or Welfare Agency
- Escondido, CA
- NPI 1386134864
-
dba Palomar Health Expresscare
- Urgent Care Clinic/Center
- Escondido, CA
- NPI 1437602703
-
dba Palomar Health Laboratory Services - PMC Downtown Escondido
- Clinical Medical Laboratory
- Escondido, CA
- NPI 1639427677
-
dba Palomar Health Laboratory Services - PMC Escondido
- Clinical Medical Laboratory
- Escondido, CA
- NPI 1639427685
-
dba Palomar Health Acute Rehabilitation
- Rehabilitation Hospital Unit
- Poway, CA
- NPI 1760004766
-
dba Palomar Health Pharmacy Services - PMC Poway
- Institutional Pharmacy
- Poway, CA
- NPI 1790801181
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Palomar Health | Operational/Managerial Control | Jun 24, 1966 | 100% |
| Diane Hansen | Corporate Officer | Dec 1, 2017 | 100% |
| Corporate Director | Dec 1, 2017 | ||
| W-2 Managing Employee | Oct 15, 2012 | ||
| Hubert Ulysses King | Corporate Officer | Apr 18, 2022 | |
| Corporate Director | Apr 18, 2022 | ||
| W-2 Managing Employee | Apr 18, 2022 | ||
| Jami L Piearson | Corporate Director | Feb 4, 2019 | |
| W-2 Managing Employee | Feb 4, 2019 | ||
| Helen S Waishkey | Corporate Officer | Aug 30, 2021 | |
| Corporate Director | Aug 30, 2021 | ||
| W-2 Managing Employee | Aug 30, 2021 | ||
| Stephanie J Baker | Corporate Officer | Feb 14, 2022 | |
| Corporate Director | Feb 14, 2022 | ||
| W-2 Managing Employee | Feb 14, 2022 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Palomar Medical Center Poway
- General Acute Care Hospital
- Poway, CA
- NPI 1376513754
Operational/Managerial Control
-
dba Palomar Medical Center Escondido
- General Acute Care Hospital
- Escondido, CA
- NPI 1457321317
Operational/Managerial Control
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Palomar Medical Center Poway | Hospital | Operational/Managerial Control (100%) | Jan 1, 1966 |
| Palomar Medical Center Escondido | Hospital | Operational/Managerial Control (100%) | Jan 1, 1966 |
| Palomar Rehabilitation Institute | Hospital | 5% Or Greater Direct Ownership Interest (49%) | Apr 27, 2021 |
Owned or controlled facilities with NPI records 3
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Palomar Medical Center Poway
- General Acute Care Hospital
- Poway, CA
- NPI 1376513754
Operational/Managerial Control
-
dba Palomar Medical Center Escondido
- General Acute Care Hospital
- Escondido, CA
- NPI 1457321317
Operational/Managerial Control
-
dba Palomar Rehabilitation Institute
- Rehabilitation Hospital
- Escondido, CA
- NPI 1831702398
5% Or Greater Direct Ownership Interest
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Palomar Medical Center Poway
- General Acute Care Hospital
- Poway, CA
- NPI 1376513754
Palomar Health
-
dba Palomar Medical Center Escondido
- General Acute Care Hospital
- Escondido, CA
- NPI 1457321317
Palomar Health
-
dba Palomar Rehabilitation Institute
- Rehabilitation Hospital
- Escondido, CA
- NPI 1831702398
Palomar Health
Practitioners & affiliated clinicians
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Poway, CA
- NPI 1295795037
Nursing home
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": "1643328000000",
"number": "1619947090",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15615 POMERADO RD",
"city": "POWAY",
"state": "CA",
"postal_code": "920642405",
"telephone_number": "858-613-4545",
"fax_number": "858-675-5181"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PALOMAR HEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PALOMAR HEALTH",
"enumeration_date": "2006-01-26",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"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": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "080000127",
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": "CA",
"license": "08000083",
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "CA",
"license": "08000083",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC70151F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55301F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "The Villas at Poway",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Villa Pomerado",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Poway, CA
- Keiloni Paje
- Genessa Pak
- Palomar Family Counseling Service, Inc.
- Palomar Health (PMC Outpatient Pharmacy - Poway)
- Palomar Health (Palomar Medical Center Poway)
- Palomar Health (Palomar Health Center for Behavioral Health - PMC Poway)
- Palomar Health (Palomar Health Acute Rehabilitation)
- Palomar Health (Palomar Health Pharmacy Services - PMC Poway)
- Palomar Health (Palomar Health Laboratory Services - PMC Poway)
- Palomar Ucsd Health Authority
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.