NPIMap

Organization Active NPI

Prime Healthcare Services - Encino LLC

  • Psychiatric Hospital Unit
  • Encino, CA
National Provider Identifier
1629242201
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
930000051 Issued in CA
Legal business name
PRIME HEALTHCARE SERVICES - ENCINO LLC
Practice address
16237 Ventura Blvd
Encino, CA 91436-2201
Phone
(818) 995-5000
NPI assigned
Apr 15, 2008
Last updated
Jan 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 930000051 CA Primary

Addresses

Primary practice location

16237 Ventura Blvd
Encino, CA 91436-2201

Mailing address

16237 Ventura Blvd
Encino, CA 91436-2201
Phone (818) 995-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080612000286 CA Part A Provider - Hospital 3274603410 Practice locations: Encino, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629242201. Details of each certification follow.

Hospital certification: CCN 05S158

Legal name
PRIME HEALTHCARE SERVICES - ENCINO LLC
Doing business as
ENCINO HOSPITAL MEDICAL CENTER
Organization structure
LLCNon-profit
Incorporated
Feb 29, 2008 in DE
Enrollment address
16237 Ventura Blvd
Encino, CA 91436-2201
Other Hospital Practice Location
Hospital subgroups
Acute care, Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services Encino LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the 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 9

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

NameRoleSinceShare
David Thorson Individual Corporate DirectorDirector Jan 1, 2013
OtherBoard Member Jan 1, 2013
Prime Healthcare Services, Inc Organization, Onterio, CA Other Jan 1, 2010
Em Garcia Individual Corporate OfficerAdministrator Jan 1, 2013
Corporate DirectorDirector Jan 1, 2013
W-2 Managing EmployeeChief Nursing Officer Jan 1, 2013
OtherBoard Member Jan 1, 2013
Jason Greenspan Individual Corporate DirectorDirector Jan 1, 2013
OtherBoard Member Jan 1, 2013
Sundeep Bhatia Individual Corporate DirectorDirector Jan 1, 2013
OtherBoard Member Jan 1, 2013
Jason Cairns Individual Corporate DirectorDirector Jan 1, 2013
OtherBoard Member Jan 1, 2013
Jacob N Rubin Individual Corporate DirectorDirector Jan 1, 2013
OtherBoard Member Jan 1, 2013
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Apr 24, 2017
Prime Healthcare Foundation Inc Organization, Ontario, CA Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2010 100%

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 1

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

FacilityTypeRoleSince
Encino Hospital Medical CenterEncino, CA, CCN 555380 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2008

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1629242201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16237 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362201",
            "telephone_number": "818-995-5000",
            "fax_number": "818-907-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16237 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362201",
            "telephone_number": "818-995-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - ENCINO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": "930000051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.