Active NPI
Alta Newport Hospital, LLC
Doing business as Foothill Regional Medical Center
- Pediatric Skilled Nursing Facility
- Tustin, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- License
- 060000178
- Legal business name
- ALTA NEWPORT HOSPITAL, LLC
- Doing business as
- Foothill Regional Medical Center
- Practice address
- 14662 Newport Ave
Tustin, CA 92780-6064 - Phone
- (714) 619-7700
- Fax
- (714) 619-7724
- NPI assigned
- Jan 14, 2014
- Last updated
- Dec 22, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Jon Elders
- Title
- Secretary
- Phone
- (714) 788-1249
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | 060000178 | CA | Primary |
Addresses
Primary practice location
14662 Newport Ave
Tustin, CA 92780-6064
Mailing address
3415 S Sepulveda Blvd FL 9
Los Angeles, CA 90034-6060
Phone (310) 943-4500
Other names 1
- Foothill Regional Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141007002798 | CA | Part A Provider - Skilled Nursing Facility | 5395975825 | Practice locations: Tustin, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1689096406. Details of each certification follow.
Skilled nursing facility certification: CCN 555730
- Legal name
- ALTA NEWPORT HOSPITAL LLC
- Doing business as
- FOOTHILL REGIONAL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 25, 1998
- Last certification
- Feb 3, 2025
- Beds
- 42
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Incorporated
- Nov 11, 2013 in CA
- Enrollment address
- 14662 Newport Ave
Tustin, CA 92780-6064 - Nursing home name
- FOOTHILL REGIONAL MEDICAL CENTER D/P SNF
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Foothill Regional Medical Center
- General Acute Care Hospital
- Tustin, CA
- NPI 1043632938
5395975825
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Foothill Regional Medical Center D/P SNF
- Overall star rating
- Health inspections
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 25, 1998
- Medicare certification status
- Active
- Certified beds
- 42
National Provider Directory
National Provider Directory- Tax ID family
- Alta Newport Hospital LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Foothill Regional Medical Center
- General Acute Care Hospital
- Tustin, CA
- NPI 1043632938
Ownership & related parties
All disclosed owners & managing parties 16
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 |
|---|---|---|---|
| Sang Bum Lee | 5% Or Greater Indirect Ownership Interest | Mar 7, 2014 | 34% |
| Adp of the SNF | Dec 23, 2024 | ||
| Robert Elders | Corporate Officer | Jun 15, 2020 | |
| MPT Picasso Investors TRS, LLC | 5% Or Greater Indirect Ownership Interest | Aug 1, 2024 | 49% |
| Glenda Luce | W-2 Managing Employee | Aug 18, 2014 | |
| Eric Samuels | Corporate Officer | Jun 3, 2019 | |
| Ivy Intermediate Holding Inc | 5% Or Greater Indirect Ownership Interest | Mar 7, 2014 | 51% |
| Alfredo Sabillo | Corporate Officer | Jul 21, 2020 | |
| PHP Holdings, LLC | 5% Or Greater Indirect Ownership Interest | Aug 1, 2024 | 100% |
| Medical Properties Trust, Inc. | 5% Or Greater Indirect Ownership Interest | Aug 1, 2024 | 49% |
| Ivy Holdings Inc | 5% Or Greater Indirect Ownership Interest | Mar 7, 2014 | 51% |
| Araceli Lonergan | W-2 Managing Employee | Jul 10, 2017 | |
| David & Alexa Topper Family Trust | 5% Or Greater Indirect Ownership Interest | Mar 7, 2014 | 17% |
| MPT Operating Partnership L P | 5% Or Greater Indirect Ownership Interest | Aug 1, 2024 | 49% |
| Chamber Inc | 5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 51% |
| Prospect Medical Holdings Inc | 5% Or Greater Indirect Ownership Interest | Mar 7, 2014 | 51% |
| Prospect Intermediate Holdings, LLC | 5% Or Greater Direct Ownership Interest | Aug 1, 2024 | 100% |
Facilities with the same owner 13
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Los Angeles Comm Hosp, Norwalk Comm Hosp & LA Comm Hosp at Bellflower
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1922001809
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
dba Southern California Hospital at Hollywood, at Van Nuys, at Culver City
- General Acute Care Hospital
- Hollywood, CA
- NPI 1023010113
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
dba Southern California Hospital at Culver City
- Rehabilitation Hospital Unit
- Culver City, CA
- NPI 1861744138
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
dba Southern California Hospital at Culver City
- Skilled Nursing Facility
- Culver City, CA
- NPI 1922350206
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
- Home Health Agency
- Providence, RI
- NPI 1811402100
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
dba Roger Williams Medical Center
- General Acute Care Hospital
- Providence, RI
- NPI 1013332014
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc
-
dba Roger Williams Medical Center
- Psychiatric Hospital Unit
- Providence, RI
- NPI 1477978476
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc
-
dba Southern New England Rehabilitation Center
- Rehabilitation Hospital Unit
- North Providence, RI
- NPI 1205251204
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc
-
dba St. Joseph Health Center
- Psychiatric Hospital Unit
- North Providence, RI
- NPI 1396160396
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc
-
dba Our Lady of Fatima Hospital
- General Acute Care Hospital
- North Providence, RI
- NPI 1871918870
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Prospect Medical Holdings Inc
-
dba VNA Health at Home
- Home Health Agency
- Watertown, CT
- NPI 1265880413
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
-
- General Acute Care Hospital
- Waterbury, CT
- NPI 1477902641
Chamber Inc, David & Alexa Topper Family Trust, Ivy Holdings Inc, Ivy Intermediate Holding Inc, Prospect Medical Holdings Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671667200000",
"number": "1689096406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 S SEPULVEDA BLVD FL 9",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900346060",
"telephone_number": "310-943-4500",
"fax_number": "310-943-4501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14662 NEWPORT AVE",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806064",
"telephone_number": "714-619-7700",
"fax_number": "714-619-7724"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALTA NEWPORT HOSPITAL, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-14",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A",
"authorized_official_last_name": "ELDERS",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "JON",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "714-788-1249"
},
"taxonomies": [
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": "CA",
"license": "060000178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Foothill Regional Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Foothill Regional Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.