NPIMap

Organization Active NPI

Emanate Health Foothill Presbyterian Hospital

Doing business as Foothill Presbyterian Hospital

  • General Acute Care Hospital
  • Glendora, CA
National Provider Identifier
1992733513
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL
Doing business as
Foothill Presbyterian Hospital
Practice address
250 S Grand Ave
Glendora, CA 91741-4218
Phone
(626) 963-8411
NPI assigned
Jun 30, 2006
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EMANATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Roger Sharma
Title
Executive VP/Cfo
Phone
(626) 938-7595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

250 S Grand Ave
Glendora, CA 91741-4218

Mailing address

PO Box 840149
Los Angeles, CA 90084-0149
Phone (626) 732-3100

Other identifiers 5

IdentifierTypeStateIssuer
HSC30597FMedicaidCA
1026OtherCABLUE CROSS SO CAL
ZZT30597FMedicaidCA
ZZT40597FMedicaidCA
ZZZA1988ZOtherCABLUE SHIELD CA

Other names 2

  • Foothill Presbyterian Hospital Doing business as
  • Foothill Presbyterian Hospital Morris L. Johnston Memorial Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080122000675 CA Part A Provider - Hospital 1052492584 Practice locations: Glendora, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992733513. Details of each certification follow.

Hospital certification: CCN 050597

Legal name
EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 28, 1973
Last certification
Sep 21, 2017
Beds
106
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 22, 1965 in CA
Enrollment address
250 S Grand Ave
Glendora, CA 91741-4218
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Emanate Health Foothill Presbyterian HospitalCCN 050597 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Part of
Citrus Valley Health Partners

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
George Ferenczi Individual Corporate Director Jun 1, 2016
Bernard Bollinger Individual Corporate Director Jan 9, 2008
Walter Allen Individual Corporate Director Jun 1, 2024
Arthur Joseph Ludwick Individual Corporate Director Jan 9, 2008
Leon J. Choiniere Individual Corporate Officer Apr 2, 2022
Gary Mathewson Individual Corporate Director Jan 9, 2008
Sanjay Natverlal Khedia Individual Corporate Director Sep 1, 2023
Raffaele M Corbisiero Individual Corporate Director Jan 1, 2024
Thomas O. Bryan Individual Corporate Director Jan 9, 2008
Clifford Charles Christ Individual Corporate Director Jan 9, 2008
Rajesh K Sharma Individual Corporate OfficerPresident/Ceo Apr 2, 2022
Lisa Fuerst Individual Corporate Director Jan 1, 2019
Philip B Maldonado Individual Corporate Director Jun 1, 2023
Patsy Gorrell Individual Corporate Director Jan 9, 2008
Mary Kirchen Individual Corporate Director Jan 9, 2008
Emanate Health Organization, Covina, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Oct 15, 2018 100%
Operational/Managerial Control Oct 15, 2018 100%
Sharon Juliana Yee Individual Corporate Director Jun 1, 2016
Lucrecia Montes Individual Corporate Director Jun 1, 2022
Brenda N Hayakawa Individual Corporate Director Jan 1, 2024
Robert Gonzales Individual Corporate Director Jan 1, 2019
Eddie Arvayo Individual Contracted Managing EmployeeMD; Feb 1, 2023
Corporate Director Feb 1, 2023

Owners & managing parties with NPI records 6

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 205

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 205

Affiliated clinicians 302

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

View all 302

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1992733513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840149",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840149",
            "telephone_number": "626-732-3100",
            "fax_number": "626-732-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414218",
            "telephone_number": "626-963-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH FOOTHILL PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMANATE HEALTH",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "626-938-7595"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30597F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SO CAL",
            "identifier": "1026",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30597F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40597F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CA",
            "identifier": "ZZZA1988Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Presbyterian Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foothill Presbyterian Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foothill Presbyterian Hospital Morris L. Johnston Memorial",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.