NPIMap

Individual provider Active NPI

Rodolfo Baguinguito Protacio, M.D.

  • Internal Medicine Physician
  • Glendale, CA
National Provider Identifier
1154320836
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A49873 Issued in CA
Practice address
1500 S Central Ave Ste 108
Glendale, CA 91204-2785
Phone
(818) 500-8739
Fax
(818) 500-0957
NPI assigned
Jul 15, 2005
Reactivated
Apr 11, 2006
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A49837 CA
Internal Medicine Physician 207R00000X A049837 CA
Internal Medicine Physician 207R00000X A49873 CA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A49837 CA

Addresses

Primary practice location

1500 S Central Ave Ste 108
Glendale, CA 91204-2785

Mailing address

1500 S Central Ave Ste 108
Glendale, CA 91204-2785
Phone (818) 500-8739

Other identifiers 1

IdentifierTypeStateIssuer
00A498370MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081203000679 CA Practitioner - Internal Medicine 8325942295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

710 S Central Ave
Suite 330
Glendale, CA 91204-4647
Phone (818) 500-8739

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A049837CAMDInternal Medicine Physician
A49873CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Primary Health Care Corp Single Specialty CurrentSince Oct 9, 2008 Accepting new patients
Jem Hospice Corporation CurrentSince Feb 1, 2025 Accepting new patients
Community Care Mobile Doctors Single Specialty CurrentSince Feb 1, 2025 Accepting new patients
Dignity Health Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Velocure Internal Medicine PastSince Sep 8, 2025 Accepting new patients
Sierra Hospice Care,Inc. PastSince Nov 3, 2010 Accepting new patients

Locations

1500 S Central Ave
Ste 108
Glendale, CA 91204
Phone (818) 242-1932

1510 S Central Ave
Ste 540
Glendale, CA 91204
Phone (818) 500-8739

710 S Central Ave
Ste 330
Glendale, CA 91204
Phone (818) 263-5737

710 S Central Ave
Ste 340
Glendale, CA 91204
Phone (818) 409-0060

275 W Hospitality Ln
Ste 314
Sn Bernrdno, CA 92408
Phone (956) 245-2275

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rodolfo.protacio.p152@direct.healthcarepartners.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 9

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

FacilityTypeRoleSince
Care Unlimited Health Services,Inc.Glendora, CA, CCN 058116 Home health agency Corporate Director (100%) Jun 16, 2016
Accurate Home Health Care, Inc.Rosemead, CA, CCN 058080 Home health agency Contracted Managing Employee Nov 1, 2022
Neighbor Care Home HealthThousand Oaks, CA, CCN 059450 Home health agency Corporate Director Oct 13, 2010
St Anthony HospiceGlendale, CA, CCN 551500 Hospice Contracted Managing Employee Mar 31, 2008
Sierra Hospice Care,Inc.Los Angeles, CA, CCN 551687 Hospice W-2 Managing Employee Nov 3, 2010
CB Homecare Hospice CorporationGlendale, CA, CCN 751628 Hospice Contracted Managing Employee (50%) Mar 24, 2017
Red Hearts Hospice IncLos Angeles, CA, CCN 751766 Hospice Contracted Managing Employee Aug 8, 2022
Vertex Hospice Care, Inc.Santa Clarita, CA, CCN A01595 Hospice Corporate Director
W-2 Managing Employee		 Apr 20, 2021
Apr 20, 2021
Santa Rosa Hospice IncAlhambra, CA, CCN A11631 Hospice Contracted Managing Employee Dec 17, 2021

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1154320836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE STE 108",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042785",
            "telephone_number": "818-500-8739",
            "fax_number": "818-500-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE STE 108",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042785",
            "telephone_number": "818-500-8739",
            "fax_number": "818-500-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTACIO",
        "first_name": "RODOLFO",
        "middle_name": "BAGUINGUITO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A49837",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A049837",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A49873",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A49837",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A498370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.