Active NPI
Jacqueline Selim Antoun, MD
- Pediatrics Physician
- San Francisco, CA
National Provider Identifier
1700527629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A187753
- Practice address
- 45 Castro St Ste 232
San Francisco, CA 94114-1027 - Phone
- (415) 565-6810
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A187753 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
45 Castro St Ste 232
San Francisco, CA 94114-1027
Mailing address
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Other practice location 1
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-2122
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Vanderbilt University School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2001 The Embarcadero
San Francisco, CA 94143-5200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A187753 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UCSF Health Medical Foundation | Pediatrics | Current | Accepting new patients |
Locations
570 Price Ave
Ste 100
Redwood City, CA 94063
Phone (650) 327-1258
1081 Market Pl
Ste 500
San Ramon, CA 94583
Phone (669) 235-4188
Interoperability endpoints
- jantoun744485@hisp.ehr.sutterhealth.org
- jantoun439756@direct-ucsfmedicalcenter.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Emeryville, CA
- NPI 1043628316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1700527629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 CASTRO ST STE 232",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141027",
"telephone_number": "415-565-6810"
}
],
"practiceLocations": [
{
"address_1": "4650 W Sunset Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900276062",
"country_code": "US",
"telephone_number": "323-361-2122",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANTOUN",
"first_name": "JACQUELINE",
"middle_name": "SELIM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A187753",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.