Kaiser Foundation Hospitals

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

060000015 Issued in CA

Legal business name

KAISER FOUNDATION HOSPITALS

Doing business as

Kaiser Foundation Hospital - Anaheim Hospice

Practice address

17542 East 17TH Street
Suite 300
Tustin, CA 92780-1960

Phone

(714) 734-4500

Fax

(714) 734-7570

NPI assigned

Feb 19, 2010

Last updated

May 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie K. Miller-Phipps

Title

Executive Director

Phone

(714) 279-4100

Specialties & licenses 1

Addresses

Other names 1

• Kaiser Foundation Hospital - Anaheim Hospice Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962724856. Details of each certification follow.

• CCN 551634 Hospice · Active · Details

Hospice certification: CCN 551634

Legal name

KAISER FOUNDATION HOSPITALS

Doing business as

KAISER ORANGE COUNTY HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 12, 2011

Last certification

Apr 20, 2018

Ownership / control type

Other

Organization structure

CorporationNon-profit

Incorporated

Feb 19, 1948 in CA

Enrollment address

17542 17TH St
Tustin, CA 92780-1960

Listed as

Kaiser Foundation Hospital Anaheim HospiceCCN 551634 · All quality measures

Ownership

Other

Certified

Dec 12, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Daniel Gussin185 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.

• Kaiser Foundation Hospitals

  • Institutional Pharmacy
  • Irwindale, CA
  • NPI 1871055483
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Found Hospital Phrmcy #67A / 67B

  • Institutional Pharmacy
  • Vacaville, CA
  • NPI 1871727891
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser FDN HSP Out HSP Phy 111

  • Community/Retail Pharmacy
  • Oakland, CA
  • NPI 1881742765
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Tri Central Home Health Agency

  • Home Health Agency
  • West Covina, CA
  • NPI 1912052838
  NPD tax ID
• Kaiser Foundation Hospitals

  • Institutional Pharmacy
  • Harbor City, CA
  • NPI 1912055666
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Hospital Morse 1St Floor Pharmacy 616

  • Community/Retail Pharmacy
  • Sacramento, CA
  • NPI 1912055724
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Riverside ESRD

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Riverside, CA
  • NPI 1922153576
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Anaheim ESRD

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Anaheim, CA
  • NPI 1922153865
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Hospital Main Pharmacy 391

  • Community/Retail Pharmacy
  • San Rafael, CA
  • NPI 1932266293
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Home Health Agency Oakland

  • Home Health Agency
  • Oakland, CA
  • NPI 1952485690
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser FDN HSP French Out Phy 321

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1972651750
  NPD tax ID
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital South San Francisco

  • General Acute Care Hospital
  • South San Francisco, CA
  • NPI 1982774337
  NPD tax ID

Locations

All disclosed owners & managing parties 22

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

Owners & managing parties with NPI records 2

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

• Deepa M. Savani, MD

  • Internal Medicine Physician
  • Vallejo, CA
  • NPI 1760560502

  Contracted Managing Employee

  CMS ownership
• Regina M Benjamin, MD

  • Family Medicine Physician
  • Bayou la Batre, AL
  • NPI 1033188339

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 79

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

Facilities with the same owner 78

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Diego

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1013062769

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Hospice Program

  • Community Based Hospice Care Agency
  • West Covina, CA
  • NPI 1053466953

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Inland Empire Hospice

  • Community Based Hospice Care Agency
  • Fontana, CA
  • NPI 1053466961

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Hospice - Martinez

  • Community Based Hospice Care Agency
  • Martinez, CA
  • NPI 1053487793

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Mental Health Ctr DP AHP

  • Psychiatric Hospital Unit
  • Los Angeles, CA
  • NPI 1063567956

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Jose

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063582989

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Roseville

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1073811378

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Fresno

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1083784672

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Home Health Santa Rosa

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1104996933

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Los Angeles HHA

  • Home Health Agency
  • Pasadena, CA
  • NPI 1124173059

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital West Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1134274897

  Kaiser Foundation Hospitals

  CMS ownership
• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital San Francisco

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1134299522

  Kaiser Foundation Hospitals

  CMS ownership

Practitioners 3

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.

• Shawnee Lee Alexander, LCSW

  • Clinical Social Worker
  • Tustin, CA
  • NPI 1124363759
  NPD (past)
• Angelica Victoria Bon, LCSW

  • Mental Health Counselor
  • Tustin, CA
  • NPI 1083916860
  NPD (past)
• Stacy D Hernandez

  • Physical Therapy Assistant
  • Tustin, CA
  • NPI 1568281228
  NPD (past)

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kent Eunbae Ahn, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Fontana, CA
  • NPI 1083762017

  Hospice

  Care Compare affiliation
• Christopher Chung

  • Family Medicine Physician
  • Seal Beach, CA
  • NPI 1578957049

  Hospice

  Care Compare affiliation
• Bita Yazdi Hernandez, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Anaheim, CA
  • NPI 1578611471

  Hospice

  Care Compare affiliation
• Raymond Wunjoe Huang, MD

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1295807527

  Hospice

  Care Compare affiliation
• Jayana Patel, MD

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1801944855

  Hospice

  Care Compare affiliation
• Elizabeth Thu Pham, M.D.

  • Internal Medicine Physician
  • Costa Mesa, CA
  • NPI 1740413681

  Hospice

  Care Compare affiliation
• Tieu O Phung, M.D.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1316964240

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1266537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1962724856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17542 EAST 17TH STREET",
            "address_2": "SUITE 300",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801960",
            "telephone_number": "714-734-4500",
            "fax_number": "714-734-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17542 EAST 17TH STREET",
            "address_2": "SUITE 300",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801960",
            "telephone_number": "714-734-4500",
            "fax_number": "714-734-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-19",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "MILLER-PHIPPS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-279-4100"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "060000015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "17542 East 17th Street",
            "address_2": "Suite 300",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927801960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Foundation Hospital - Anaheim Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Foundation Hospital - Anaheim Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kabacare Tustin Ca PC
• Gena E Kadar, D.C.
• Mimi Kahn, MSW,LCSW
• Kaiser Foundation Health Plan Inc (Kaiser Permanente Pharmacy #379)
• Kaiser Foundation Hospitals (Kaiser Foundation Hospital Anaheim Home Health AG.)
• Kaizen Behavior LLC
• Linh Kamikawa
• Malissa Kanczula
• Anjala Kanda, DPM
• David Kang

• Community Based Hospice Care Agency in Tustin, CA
• Providers in Tustin, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.

Verify at the official NPI Registry.