St Anthony Foundation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

220000400 Issued in CA

Legal business name

ST ANTHONY FOUNDATION

Doing business as

St Anthony Medical Clinic

Practice address

150 Golden Gate Ave FL 2
San Francisco, CA 94102-3810

Phone

(415) 241-8320

Fax

(415) 440-7776

NPI assigned

Nov 19, 2010

Last updated

Mar 2, 2022By 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. Ann Catherine Valdes, M.D.

Title

Medical Director

Phone

(415) 592-2712

Specialties & licenses 2

Addresses

Other names 1

• St Anthony Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356643654. Details of each certification follow.

• CCN 751917 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 751917

Legal name

ST ANTHONY FOUNDATION

Doing business as

ST ANTHONY MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 18, 2017

Last certification

Jan 18, 2017

Ownership / control type

Non-profit – church related

Organization structure

CorporationNon-profit

Incorporated

Sep 26, 2001 in CA

Enrollment address

2ND FL
150 Golden Gate Ave
San Francisco, CA 94102-3810

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 Foundation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St. Anthony Free Medical Clinic

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1356555833
  NPD tax ID

Locations

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 10

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.

• Crystal L Uken, NP

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1730807769
  NPD
• Angela Alvarez

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1215334222
  NPD (past)
• David Ernest Corner, M.D.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1356872394
  NPD (past)
• Kameron Graham, FNP-C

  • Nurse Practitioner
  • San Francisco, CA
  • NPI 1194316588
  NPD (past)
• Gerdenio Medard Manuel

  • Psychologist
  • San Francisco, CA
  • NPI 1427588508
  NPD (past)
• Natalie M Sauro, P.N.P.

  • Pediatric Nurse Practitioner
  • San Francisco, CA
  • NPI 1760752315
  NPD (past)
• Anja Schmitz, PH.D.

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1578012019
  NPD (past)
• Daniel Michael Segundo, LCSW

  • Clinical Social Worker
  • San Francisco, CA
  • NPI 1285429530
  NPD (past)
• Ani Serralta Seuylemezian, ASW

  • Clinical Social Worker
  • San Francisco, CA
  • NPI 1255818902
  NPD (past)
• Ryan Melone, LMHC, LPCC

  • Mental Health Counselor
  • Burlington, MA
  • NPI 1770206443
  NPD (past)

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1356643654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 GOLDEN GATE AVE FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023810",
            "telephone_number": "415-241-8320",
            "fax_number": "415-440-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 GOLDEN GATE AVE FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023810",
            "telephone_number": "415-241-8320",
            "fax_number": "415-440-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "415-592-2712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "220000400",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Anthony Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rahul Srivastava, MD
• Michelle Sriwongtong, MD
• Marilyn Frances Sronce, LAC AC3484
• Lina Srouji, DDS
• SS Integrative Medical Services Inc
• Ruth St Fort, MD, MPH, MS
• St Francis Ophthalmology Group
• Tiffany St Jean
• Rhea Bette St Julien, MFT
• Ralph St Luce, MD

• Primary Care Clinic/Center in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.