ST JUDE HOSPITAL INC
NPI 1194926279
General Acute Care Hospital in Fullerton, CA

Q: What is St Jude Hospital Inc's NPI number?

The NPI number for St Jude Hospital Inc is 1194926279. It was assigned to this organization in the NPPES registry on May 29, 2007. The provider is doing business as Providence St. Jude Medical Center.

Q: What is St Jude Hospital Inc's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Active since May 29, 2007

101 E VALENCIA MESA DR, FULLERTON, CA 92835(714) 871-3280(714) 870-3525 Get Directions Write a Review

NPPES record last updated: May 9, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 9, 2025, Nov 18, 2020 (2 updates tracked since 2020).

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About St Jude Hospital Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JUDE HOSPITAL INC (NPI 1194926279), doing business as Providence St. Jude Medical Center, is a healthcare organization registered as a general acute care hospital in Fullerton, California and active in the NPI registry since May 2007. The organization lists Donald W Anderson, Assistant Secretary Enrollments, as its authorized official.

NPPES Registry Identity

NPI1194926279

Entity TypeOrganization

Primary Taxonomy282N00000X

Legal Business NameST JUDE HOSPITAL INC

Location Address101 E VALENCIA MESA DRFullerton, CA 92835-3809

Mailing Address2767 E Imperial Hwy, Second FloorBrea, CA 92821-6713 · (714) 870-3510 · Fax (714) 870-3525

Phone(714) 871-3280

Fax(714) 870-3525

Organization SubpartNo

Authorized OfficialDonald W AndersonAssistant Secretary Enrollments · (425) 358-9786

Enumeration DateMay 29, 2007

Last NPPES UpdateMay 9, 20252 updates tracked since enumeration

NPPES CertifiedMay 9, 2025

✔ NPI 1194926279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals

Taxonomy Code282N00000X

License✔ Licensed in CA · 060000173

Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

101 E VALENCIA MESA DR, Fullerton, CA 92835

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Other Names 1

Doing Business AsProvidence St. Jude Medical Center

Other Identifiers 2

Other1194926279CA · Medicare Outpatient

MedicaidZZT40168FCA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St Jude Hospital Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateCaliforniaEnrollment IDO20050315001161Part A · HospitalDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PIUS J. KIM M.D.

Internal Medicine