NPIMap

Organization Active NPI

Pih Health Whittier Hospital

Doing business as Pih Health Hospice

  • Community Based Hospice Care Agency
  • La Mirada, CA
National Provider Identifier
1760487987
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PIH HEALTH WHITTIER HOSPITAL
Doing business as
Pih Health Hospice
Practice address
15050 Imperial Hwy
La Mirada, CA 90638-1301
Phone
(562) 902-7763
Fax
(562) 944-6169
NPI assigned
Jun 15, 2005
Organization subpart
Yes
Parent organization
PIH HEALTH HOSPITAL WHITTIERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Sue R Ponce (Aka Carlson)
Title
Specia Lprojects
Phone
(562) 698-0811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

15050 Imperial Hwy
La Mirada, CA 90638-1301

Mailing address

15050 Imperial Hwy
La Mirada, CA 90638-1301
Phone (562) 902-7763

Other identifiers 1

IdentifierTypeStateIssuer
HPC01542FMedicaidCA

Other names 2

  • PIH HEALTH HOSPICE Doing business as
  • PIH Health Hospital Whittier Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041229000884 CA Part A Provider - Hospice 3678545308 Practice locations: La Mirada, CA; Whittier, CA

Hospice certification: CCN 051542

Legal name
PIH HEALTH WHITTIER HOSPITAL
Doing business as
PIH HEALTH HOME HEALTHCARE - HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 6, 1989
Last certification
Jul 11, 2019
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Feb 2, 1954 in CA
Enrollment address
15050 Imperial Hwy
La Mirada, CA 90638-1301

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of PresbyterianCCN 051542 · All quality measures
Ownership
Other
Certified
Jan 6, 1989
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0944023Pih Health Hospice15050 Imperial Hwy, La Mirada, CA 90638Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Intercom H9 organizations share this tax ID, including this one
Part of
Presbyterian Intercom H

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Marissa Goldberg Individual Corporate DirectorBoard Member Oct 1, 2021
Melanie Catherine Batiste Individual Corporate DirectorBoard Member Oct 21, 2021
Vidhyashankaran Mahalingamshivaraman Individual Corporate OfficerChief Financial Officer Apr 12, 2021
W-2 Managing EmployeeChief Financial Officer Apr 12, 2021
Operational/Managerial ControlChief Financial Officer Apr 12, 2021
J Richard Atwood Individual Corporate DirectorBoard Member Apr 25, 2005
Charlotte a Weaver Individual Corporate DirectorBoard Member Oct 10, 2016
Jane B Dicus Individual Corporate DirectorBoard Member Mar 12, 2007
Adrian D Crisan Individual Corporate DirectorBoard Member Oct 1, 2019
Pih Health Whittier Hospital Organization, Whittier, CA Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2013 100%
Susanne R Ponce Individual W-2 Managing EmployeeSpecial Projects May 4, 1983
Shelly L Necke Individual W-2 Managing EmployeeAd; Jul 1, 2015
Operational/Managerial ControlVice President, Post-Acute Care Jul 1, 2015
Hamilton J Hamar Individual Corporate DirectorBoard Member Oct 10, 2016
Nathan E Hashimoto Individual W-2 Managing EmployeeMD; Dec 1, 2022
Operational/Managerial ControlHospice Medical Director Dec 1, 2022
Jay W Brown Individual Corporate DirectorBoard Member Mar 1, 2023
Sudhaker H Nayak Individual Corporate DirectorBoard Member Dec 13, 2010
William Harold Roth Individual Corporate DirectorBoard Member Mar 1, 2023
Blayne H Cutler Individual Corporate DirectorBoard Member Oct 9, 2017
Eduardo a Tovar Individual Corporate DirectorBoard Member Mar 26, 2021
Peter P Greaney Individual Corporate DirectorBoard Member Nov 13, 2018
Patrick L Monroe Individual Corporate DirectorBoard Member Oct 10, 2016
James R West Individual Corporate OfficerPresident and Ceo Oct 1, 2013
Corporate DirectorPresident and Ceo Oct 1, 2013
W-2 Managing EmployeePresident and Ceo Oct 1, 2013
Kenton C Woods Individual Corporate DirectorBoard Member Mar 28, 2005
Paul a Treinen Individual Corporate DirectorBoard Member Nov 12, 2019
Alex F Alvarez Individual Corporate DirectorBoard Member Oct 9, 2017

Owners & managing parties with NPI records 10

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
Pih Health Whittier Hospital Transitional Care UnitWhittier, CA, CCN 555654 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Feb 15, 1996
Nov 8, 2024
Dec 13, 2024
Pih Health Good Samaritan HospitalLos Angeles, CA, CCN 555927 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Feb 19, 2025

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 2

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

Practitioners & affiliated clinicians

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": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1760487987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15050 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-7763",
            "fax_number": "562-944-6169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15050 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-7763",
            "fax_number": "562-944-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIH HEALTH WHITTIER HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIH HEALTH HOSPITAL WHITTIER",
        "enumeration_date": "2005-06-15",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "PONCE (AKA CARLSON)",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPECIA LPROJECTS",
        "authorized_official_telephone_number": "562-698-0811"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HPC01542F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIH HEALTH HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIH Health Hospital Whittier",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.