NPIMap

Organization Active NPI

Hoag Memorial Hospital Presbyterian

  • Rehabilitation Hospital Unit
  • Newport Beach, CA
National Provider Identifier
1750875670
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
Practice address
1 Hoag Dr
Newport Beach, CA 92663
Phone
(949) 764-3900
NPI assigned
Jun 15, 2018
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Robert T Braithwaite
Title
President & Ceo
Phone
(949) 764-4624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663

Mailing address

1 Hoag Dr
Newport Beach, CA 92663-4162

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180716000516 CA Part A Provider - Hospital 5799677860 Practice locations: Newport Beach, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750875670. Details of each certification follow.

Hospital certification: CCN 05T224

Legal name
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
Organization structure
CorporationNon-profit
Incorporated
May 22, 1944 in CA
Enrollment address
1 Hoag Dr
Newport Beach, CA 92663-4162
Hospital Rehabilitation Unit
Hospital subgroups
General, Acute care, Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
The Fudge Family Acute Rehabilitation CenterCCN 05T224 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2019

National Provider Directory

National Provider Directory
Tax ID family
Hoag Presbyterian Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations (25 of 27)

26671 Aliso Creek Rd
Ste 106
Aliso Viejo, CA 92656
Phone (949) 764-7555

1901 Newport Blvd
Ste 175
Costa Mesa, CA 92627
Phone (949) 764-6240

19582 Beach Blvd
Ste 150160
Huntington Beach, CA 92648
Phone (714) 378-4992

19582 Beach Blvd
Ste 190
Huntington Beach, CA 92648
Phone (949) 764-5871

16105 Sand Canyon Ave
Ste 100
Irvine, CA 92618
Phone (949) 557-0250

16105 Sand Canyon Ave
Ste 150
Irvine, CA 92618
Phone (949) 557-0210

16105 Sand Canyon Ave
Ste 220
Irvine, CA 92618
Phone (949) 474-5730

16300 Sand Canyon Ave
Ste 100
Irvine, CA 92618
Phone (949) 754-1344

16305 Sand Canyon Ave
Ste 100
Irvine, CA 92618
Phone (949) 557-0150

16305 Sand Canyon Ave
Ste 120
Irvine, CA 92618
Phone (949) 557-0160

16305 Sand Canyon Ave
Ste 150
Irvine, CA 92618
Phone (949) 557-0170

16305 Sand Canyon Ave
Ste 230
Irvine, CA 92618
Phone (949) 557-0130

16305 Sand Canyon Ave
Ste 270
Irvine, CA 92618
Phone (949) 557-0120

16405 Sand Canyon Ave
Ste 100
Irvine, CA 92618
Phone (239) 370-1845

4870 Barranca Pkwy
Ste 100
Irvine, CA 92604
Phone (949) 451-6000

6352 Irvine Blvd
Irvine, CA 92620
Phone (949) 451-6000

1 Hoag Dr
Bldg 41
Newport Beach, CA 92663
Phone (949) 764-4060

1 Hoag Dr
Bldg 47
Newport Beach, CA 92663
Phone (949) 764-5528

510 Superior Ave
Ste 100
Newport Beach, CA 92663
Phone (949) 764-5747

510 Superior Ave
Ste 110
Newport Beach, CA 92663
Phone (949) 764-5600

510 Superior Ave
Ste 130
Newport Beach, CA 92663
Phone (949) 764-6065

510 Superior Ave
Ste 140
Newport Beach, CA 92663
Phone (949) 764-5600

510 Superior Ave
Ste 280
Newport Beach, CA 92663
Phone (949) 646-2012

520 Superior Ave
Ste 100
Newport Beach, CA 92663
Phone (949) 764-5645

520 Superior Ave
Ste 100195
Newport Beach, CA 92663
Phone (949) 764-5594

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Daniel Young Individual Corporate DirectorBoard Member Jul 1, 2015 5.88%
Cynthia Stokke Individual Corporate DirectorBoard Member Jan 7, 2013 5.88%
Gary McKitterick Individual Corporate DirectorBoard Member Nov 14, 2007 5.88%
Andrew R Guarni Individual Corporate OfficerSVP & Chief Financial Officer Jul 1, 2014
W-2 Managing EmployeeSVP & Chief Financial Officer Jul 1, 2014
Joel Alan Katz Individual Corporate DirectorBoard Member Jul 1, 2016 5.88%
Karen Linden Individual Corporate DirectorBoard Member Oct 1, 2012 5.88%
Jeffrey Margolis Individual Corporate DirectorBoard Member Oct 1, 2008 5.88%
Michael Ricks Individual Corporate OfficerExec VP & Chief Operating Officer Jul 1, 2015
W-2 Managing EmployeeExec VP & Chief Operating Officer Jul 1, 2015
Pamela Massey Individual Corporate DirectorBoard Member Oct 1, 2013 5.88%
Miles Chang Individual Corporate DirectorBoard Member Jul 1, 2014 5.88%
Paul Heeschen Individual Corporate DirectorBoard Member Jul 1, 2017 5.88%
Robert Evans Individual Corporate DirectorBoard Member Jul 1, 2015 5.88%
George Wood Individual Corporate DirectorBoard Member Oct 1, 2011 5.88%
Raymond L Ricci Individual Corporate DirectorBoard Member Oct 1, 2012 5.88%
Robert Braithwaite Individual Corporate OfficerPresident & Ceo Mar 1, 2013
W-2 Managing EmployeePresident & Ceo Mar 1, 2013
James Shepherdson, III Individual Corporate DirectorBoard Member Jul 1, 2016 5.88%
Vicki Booth Individual Corporate DirectorBoard Member Jul 1, 2017 5.88%
Rodney F Hochman Individual Corporate DirectorBoard Member Jul 1, 2016 5.88%
Dennis Gilmore Individual Corporate DirectorBoard Member Jan 7, 2013 5.88%
Robert Brunswick Individual Corporate DirectorBoard Member Jan 1, 2018 5.88%

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Hoag Memorial Hospital PresbyterianNewport Beach, CA, CCN 050224 Hospital Other Mar 1, 2013
Hoag Orthopedic Institute, LLCIrvine, CA, CCN 050769 Hospital 5% Or Greater Direct Ownership Interest (51%) Nov 25, 2008
Hoag Home HealthNewport Beach, CA, CCN 557412 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2022
Hoag HospiceNewport Beach, CA, CCN 551666 Hospice 5% Or Greater Indirect Ownership Interest (100%) Dec 29, 2020

Owned or controlled facilities with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 18

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 18

Affiliated clinicians 6

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": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1750875670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-764-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOAG MEMORIAL HOSPITAL PRESBYTERIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "BRAITHWAITE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "949-764-4624"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.