St Anthony Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ST ANTHONY HOSPICE

Practice address

512 E Wilson Ave
Suite 208
Glendale, CA 91206-4351

Phone

(818) 241-0082

Fax

(818) 241-0018

NPI assigned

May 19, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Corazon Mugas Co

Title

Ceo

Phone

(818) 521-9714

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN 551500

Legal name

ST ANTHONY HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 22, 2006

Last certification

Mar 25, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Feb 20, 2001 in CA

Enrollment address

512 E Wilson Ave
#208
Glendale, CA 91206-4351

Listed as

St Anthony HospiceCCN 551500

Ownership

For-Profit

Certified

Sep 22, 2006

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

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

• Rodolfo Baguinguito Protacio, M.D.

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1154320836

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rodolfo Baguinguito Protacio, M.D.

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1154320836

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1255549473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E WILSON AVE",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064351",
            "telephone_number": "818-241-0082",
            "fax_number": "818-241-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 E WILSON AVE",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064351",
            "telephone_number": "818-241-0082",
            "fax_number": "818-241-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-19",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "CO",
        "authorized_official_first_name": "CORAZON",
        "authorized_official_middle_name": "MUGAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-521-9714",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HPC01800F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Glendale, CA
• Providers in Glendale, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.