Individual provider Active NPI

Anthonia Atinuke Sulaiman

  • Family Nurse Practitioner
  • Newhall, CA
National Provider Identifier
1154724284
Registry record updated Oct 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
595196 Issued in CA
Practice address
24221 La Glorita Cir
Newhall, CA 91321-2303
Phone
(661) 609-9864
NPI assigned
Oct 3, 2014
Last updated
Oct 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 595196 CA Primary

Addresses

Primary practice location

24221 La Glorita Cir
Newhall, CA 91321-2303

Mailing address

24221 La Glorita Cir
Newhall, CA 91321-2303
Phone (661) 609-9864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161027001192 CA Practitioner - Nurse Practitioner 9032497912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John's Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

5059 York Blvd
Los Angeles, CA 90042-1713
Phone (323) 344-4144

6505 8TH Ave
Los Angeles, CA 90043-4313
Phone (323) 750-9232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
595196CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Sep 26, 2016 Accepting new patients
St. Johns Community Health Current Accepting new patients
Comprehensive Community Health Centers Inc CurrentSince Sep 13, 2021 Accepting new patients
Comprehensive Community Health Centers, Inc CurrentSince Sep 13, 2021 Accepting new patients
Comprehensive Community Health Centers Inc Current Accepting new patients
St. Johns Community Health CurrentSince Sep 26, 2016 Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

4251 Crenshaw Blvd
Los Angeles, CA 90008
Phone (323) 295-5577

5059 York Blvd
Los Angeles, CA 90042
Phone (323) 344-4144

6505 8th Ave
Los Angeles, CA 90043
Phone (323) 750-9232

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: anthonia.sulaiman@sjch.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1154724284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24221 LA GLORITA CIR",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212303",
            "telephone_number": "661-609-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24221 LA GLORITA CIR",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212303",
            "telephone_number": "661-609-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAIMAN",
        "first_name": "ANTHONIA",
        "middle_name": "ATINUKE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "595196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.