NPIMap

Organization Active NPI

St Anthony Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1225188204
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
837 W Imperial Hwy
Los Angeles, CA 90044-4110
Phone
(323) 755-9555
NPI assigned
Jan 11, 2007
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

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
Dr. Awad Anthony, M.DNPI 1811047830
Title
Ceo
Phone
(323) 469-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

837 W Imperial Hwy
Los Angeles, CA 90044-4110

Mailing address

6368 Hollywood Blvd
Hollywood, CA 90028-6320
Phone (323) 469-5555

Other practice location 1

1145 E Compton Blvd
Compton, CA 90221-3307
Phone (310) 637-5555

Other identifiers 2

IdentifierTypeStateIssuer
FHC70866FMedicaidCA
HAP70866FOtherCAFAMILY PACT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050817000807 CA Part A Provider - Federally Qualified Health Center (FQHC) 5395638092 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225188204. Details of each certification follow.

Federally qualified health center certification: CCN 051030

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
837 W Imperial Hwy
Los Angeles, CA 90044-4110

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 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.

Ownership & related parties

All disclosed owners & managing parties 11

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 DirectorChairperson Sep 29, 2016
Raada Morcos Individual Corporate DirectorBoard Member Jul 30, 2015
Mayra Granillo Individual Corporate DirectorVice Chairperson Aug 27, 2015
George Fahmy Individual Corporate Officer Jan 9, 2013
W-2 Managing EmployeeFinancial Controller Jan 9, 2013
Ronald Veazie Individual Corporate DirectorSecretary of the Board Nov 17, 2016
Faten Gereyas Individual Corporate DirectorBoard Member Nov 18, 2009
Ewillder Berry Individual Corporate DirectorBoard Member Dec 12, 2018
St Anthony Medical Centers Organization, Los Angeles, CA Corporation Operational/Managerial Control Jan 1, 2000
Julio Garcia Individual Corporate DirectorBoard Member Mar 30, 2017
Awad Anthony Individual Corporate OfficerCeo Jan 3, 2000
W-2 Managing Employee Jan 3, 2000
Senen Diaz Individual Corporate DirectorBoard Member Dec 23, 2011

Owners & managing parties with NPI records 4

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

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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": "1225188204",
    "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",
            "fax_number": "323-466-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 W IMPERIAL HWY",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900444110",
            "telephone_number": "323-755-9555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1145 E Compton Blvd",
            "address_purpose": "LOCATION",
            "city": "Compton",
            "state": "CA",
            "postal_code": "902213307",
            "country_code": "US",
            "telephone_number": "310-637-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "FHC70866F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT",
            "identifier": "HAP70866F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.