Active NPI
St Anthony Medical Centers
- Federally Qualified Health Center (FQHC)
- Hawthorne, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- ST ANTHONY MEDICAL CENTERS
- Practice address
- 13865 Hawthorne Blvd
Hawthorne, CA 90250-7011 - Phone
- (310) 331-0555
- Fax
- (310) 759-0555
- NPI assigned
- Sep 30, 2024
- Organization subpart
- Yes
- Parent organization
- ST.ANTHONY MEDICAL CENTERS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rita M George
- Title
- Coo
- Phone
- (661) 388-1543
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
13865 Hawthorne Blvd
Hawthorne, CA 90250-7011
Mailing address
13865 Hawthorne Blvd
Hawthorne, CA 90250-7011
Phone (310) 331-0555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251114003845 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 5395638092 | Practice locations: Hawthorne, CA |
Federally qualified health center certification: CCN A11014
- Legal name
- ST ANTHONY MEDICAL CENTERS
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 30, 2025
- Last certification
- Oct 30, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 13865 Hawthorne Blvd
Hawthorne, CA 90250-7011
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Federally Qualified Health Center (FQHC)
- Hollywood, CA
- NPI 1063562130
5395638092
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1225188204
5395638092
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1952451031
5395638092
National Provider Directory
National Provider Directory- Tax ID family
- St Anthony Medical Centers
- Part of
- St Anthony Medical Centers
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Federally Qualified Health Center (FQHC)
- Hollywood, CA
- NPI 1063562130
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1225188204
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1952451031
Locations
13865 Hawthorne Blvd
Hawthorne, CA 90250
Phone (310) 331-0555
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Sareta Fernandes | Corporate Director | Sep 29, 2016 | |
| Raada Morcos | Corporate Director | Nov 17, 2016 | |
| Mayra Granillo | Corporate Director | Aug 27, 2015 | |
| George Fahmy | Corporate Officer | Jan 9, 2013 | |
| W-2 Managing Employee | Jan 9, 2013 | ||
| Ronald Veazie | Corporate Director | Nov 17, 2016 | |
| Faten Gereyas | Corporate Director | Nov 18, 2009 | |
| Ewillder Berry | Corporate Director | Dec 12, 2018 | |
| Thelma Vizier | Corporate Director | Jun 26, 2025 | |
| Julio Garcia | Corporate Director | Mar 30, 2017 | |
| Maria Garcia-Gonzalez | Corporate Director | Jun 26, 2025 | |
| Rosa Rivera | Corporate Director | Jun 26, 2025 | |
| Gabriela Guerrero | Corporate Director | Jun 26, 2025 | |
| Awad Anthony | Corporate Officer | Jan 3, 2000 | |
| W-2 Managing Employee | Jan 3, 2000 | ||
| Florida Juse | Corporate Director | Jun 26, 2025 | |
| Senen Diaz | Corporate Director | Dec 23, 2011 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Hollywood, CA
- NPI 1811047830
Corporate Officer, W-2 Managing Employee
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| St Anthony Medical Centers | Federally qualified health center | Operational/Managerial Control | Jan 1, 2000 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1225188204
Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Hollywood, CA
- NPI 1811047830
-
- Obstetrics Physician
- Hawthorne, CA
- NPI 1770702417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727654400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757030400000",
"number": "1194543124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13865 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902507011",
"telephone_number": "310-331-0555",
"fax_number": "310-759-0555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13865 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902507011",
"telephone_number": "310-331-0555",
"fax_number": "310-759-0555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST ANTHONY MEDICAL CENTERS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST.ANTHONY MEDICAL CENTERS",
"enumeration_date": "2024-09-30",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A",
"authorized_official_last_name": "GEORGE",
"authorized_official_first_name": "RITA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "661-388-1543"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hawthorne, CA
- South Bay Electrophysiology Inc
- South Bay Home Health Agency, Inc
- South Bay Neurological Diagnostic Center, Inc
- Southern California Permanente Medical Group
- Sparks Winn
- Otto Evans Stallworth, M.D.
- Velma Gwendolyn Staples, MA, LMFT
- Mary Starks, FNP-C
- Starlight Mental Health Solutions
- Christan Starling
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.