NPIMap

Organization Active NPI

Marin General Hospital

  • Psychiatric Hospital Unit
  • Greenbrae, CA
National Provider Identifier
1942267869
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MARIN GENERAL HOSPITAL
Practice address
250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone
(415) 925-7000
Fax
(415) 925-7518
NPI assigned
Apr 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stephen Roland Thompson
Title
Director PFS
Phone
(415) 925-7516

Specialties & licenses 1

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

Addresses

Primary practice location

250 Bon Air Rd
Greenbrae, CA 94904-1702

Mailing address

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 925-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111027000930 CA Part A Provider - Hospital 7618057274 Practice locations: Greenbrae, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942267869. Details of each certification follow.

Hospital certification: CCN 05S360

Legal name
MARIN GENERAL HOSPITAL
Doing business as
MARINHEALTH MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
May 8, 1981 in CA
Enrollment address
250 Bon Air Rd
Greenbrae, CA 94904-1702
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric 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).

National Provider Directory

National Provider Directory
Tax ID family
Marin General Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Ann Sparkman Individual Corporate Director Jan 10, 2012
Jennifer Rienks Individual Corporate Director Nov 2, 2010
David G Klein Individual Corporate Officer Sep 1, 2020
Operational/Managerial ControlCeo Sep 1, 2020
Brian Su Individual Corporate Director Jan 1, 2019
Eric Brettner Individual Corporate OfficerCfo Sep 25, 2019
Marin Healthcare District Organization, Greenbrae, CA Non-profit Operational/Managerial Control Jun 30, 2010 100%
Samantha a Ramirez Individual Corporate Director Jan 1, 2023
Edward Alfrey Individual Corporate Director Jan 1, 2021

Owners & managing parties with NPI records 2

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

Facilities with the same owner 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942267869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-925-7000",
            "fax_number": "415-925-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-925-7000",
            "fax_number": "415-925-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "ROLAND",
        "authorized_official_title_or_position": "DIRECTOR PFS",
        "authorized_official_telephone_number": "415-925-7516"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.