Organization Active NPI

St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
National Provider Identifier
1194543124
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
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 CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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).

National Provider Directory

National Provider Directory
Tax ID family
St Anthony Medical Centers4 organizations share this tax ID, including this one
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.

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.

NameRoleSinceShare
Sareta Fernandes Individual Corporate DirectorTreasurer of the Board of Directors Sep 29, 2016
Raada Morcos Individual Corporate DirectorBoard Member Nov 17, 2016
Mayra Granillo Individual Corporate DirectorBoard Member Aug 27, 2015
George Fahmy Individual Corporate Officer Jan 9, 2013
W-2 Managing EmployeeFinancial Controller Jan 9, 2013
Ronald Veazie Individual Corporate DirectorChairperson ¿President" Nov 17, 2016
Faten Gereyas Individual Corporate DirectorBoard Member Nov 18, 2009
Ewillder Berry Individual Corporate DirectorBoard Member Dec 12, 2018
Thelma Vizier Individual Corporate DirectorBoard Member Jun 26, 2025
Julio Garcia Individual Corporate DirectorVice Chairperson Mar 30, 2017
Maria Garcia-Gonzalez Individual Corporate DirectorBoard Member Jun 26, 2025
Rosa Rivera Individual Corporate DirectorBoard Member Jun 26, 2025
Gabriela Guerrero Individual Corporate DirectorBoard Member Jun 26, 2025
Awad Anthony Individual Corporate OfficerCeo Jan 3, 2000
W-2 Managing EmployeeCeo Jan 3, 2000
Florida Juse Individual Corporate DirectorBoard Member Jun 26, 2025
Senen Diaz Individual Corporate DirectorBoard Member 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.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
St Anthony Medical CentersLos Angeles, CA, CCN 051030 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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

Sources for this page

Verify at the official NPI Registry.