NPIMap

Organization Active NPI

County of San Diego

  • Skilled Nursing Facility
  • Santee, CA
National Provider Identifier
1962556290
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COUNTY OF SAN DIEGO
Practice address
655 Park Center Dr
Santee, CA 92071-6957
Phone
(619) 596-5500
Fax
(619) 596-5584
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Mr. Walter Hekimian
Title
Administrator
Phone
(619) 596-5597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

655 Park Center Dr
Santee, CA 92071-6957

Mailing address

655 Park Center Dr
Santee, CA 92071-6957
Phone (619) 596-5500

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05008FMedicaidCA

Other names 1

  • EDGEMOOR HOSPITAL DPSNF Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040423001418 CA Part B Supplier - Clinic/Group Practice 8123014057 Receives reassigned benefits from 107 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; Santee, CA; El Cajon, CA
O20100611000619 CA Part A Provider - Skilled Nursing Facility 8123014057 Practice locations: Santee, CA

Skilled nursing facility certification: CCN 055008

Legal name
COUNTY OF SAN DIEGO
Doing business as
EDGEMOOR HOSPITAL DPSNF
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jul 25, 2024
Beds
192
Ownership / control type
County
Organization structure
GovernmentNon-profit
Enrollment address
655 Park Center Dr
Santee, CA 92071-6957
Nursing home name
EDGEMOOR HOSPITAL

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edgemoor HospitalCCN 055008
Overall star rating
4 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
192155.5 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $41,895

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Edgemoor Geriatric Hospital101 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Erin Chancler Individual Operational/Managerial Control Mar 27, 2020
Managing Control - Governing Body Mar 27, 2020
Adp of the SNF Mar 27, 2020
Darren Kasai Individual Operational/Managerial Control Feb 10, 2023
Managing Control - Governing Body Feb 10, 2023
Adp of the SNF Feb 10, 2023
Individual Adp of the SNF Jan 1, 2019
Rebecca Lynne Ferrini Individual Operational/Managerial Control Jul 1, 2009
Managing Control - Governing Body Jul 1, 2009
Adp of the SNF Jul 1, 2009
County of San Diego Organization, Santee, CA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Operational/Managerial Control Jan 1, 1966 100%
Adp of the SNF Jul 1, 2009

Owners & managing parties with NPI records 3

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

  • County of San Diego
    • Public Health or Welfare Agency
    • San Diego, CA
    • NPI 1225255375

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • County of San Diego
    • Ambulance
    • San Diego, CA
    • NPI 1316685159

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Rebecca Ferrini, MD
    • Preventive Medicine/Occupational Environmental Medicine Physician
    • Santee, CA
    • NPI 1598842551

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1962556290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 PARK CENTER DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920716957",
            "telephone_number": "619-596-5500",
            "fax_number": "619-596-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 PARK CENTER DR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920716957",
            "telephone_number": "619-596-5500",
            "fax_number": "619-596-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "HEKIMIAN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-596-5597",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05008F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDGEMOOR HOSPITAL DPSNF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santee, CA

Sources for this page

Verify at the official NPI Registry.