St Anthony Medical Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ST ANTHONY MEDICAL CENTERS

Practice address

6368 Hollywood Blvd
Hollywood, CA 90028-6320

Phone

(323) 469-5555

NPI assigned

Jan 11, 2007

Last updated

Sep 5, 2025By 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

Dr. Awad Anthony, M.DNPI 1811047830

Title

Ceo

Phone

(323) 469-5555

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063562130. Details of each certification follow.

• CCN 051031 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 051031

Legal name

ST ANTHONY MEDICAL CENTERS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 14, 2005

Last certification

Oct 14, 2005

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Sep 20, 1998 in CA

Enrollment address

6368 Hollywood Blvd
Los Angeles, CA 90028-6320

Other NPIs with the same Medicare PAC ID 3

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

• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1194543124

  5395638092

  Same PAC ID
• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1225188204

  5395638092

  Same PAC ID
• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1952451031

  5395638092

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

St Anthony Medical Cent4 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.

• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1194543124
  NPD tax ID
• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1225188204
  NPD tax ID
• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1952451031
  NPD tax ID

Locations

All disclosed owners & managing parties 10

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 1

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

• Awad Anthony, M.D

  • Family Medicine Physician
  • Hollywood, CA
  • NPI 1811047830

  Corporate Officer, W-2 Managing Employee

  CMS ownership

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1225188204

  Operational/Managerial Control

  CMS ownership

Practitioners 1

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.

• Awad Anthony, M.D

  • Family Medicine Physician
  • Hollywood, CA
  • NPI 1811047830
  Authorized official Same address or phone

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1063562130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "CA",
            "postal_code": "900286320",
            "telephone_number": "323-469-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6368 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "CA",
            "postal_code": "900286320",
            "telephone_number": "323-469-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "AWAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-469-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70863F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY  PACT",
            "identifier": "HAP70863F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Sevilla, OTR/L
• Vernell Sexton
• Silver Wisdom Adult Day Healthcare Center, Inc.
• Andrew Somers
• Southern California Healthcare System, Inc (Southern California Hospital at Hollywood, at Van Nuys, at Culver City)
• Sung Kim, M.D., Apc
• Supervista North America (brillen.com #024136)
• Melissa Susac, MFT
• Talia Tabaroki, PHARMD.
• Tak Sun Tan

• Federally Qualified Health Center (FQHC) in Hollywood, CA
• Providers in Hollywood, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.