Satellite Healthcare of Austin LLC

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Austin, TX

NPI 1023639739 · NPPES record last updated Nov 2, 2023

Key facts

NPI
1023639739
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
SATELLITE HEALTHCARE OF AUSTIN LLC
Practice address
9811 S Interstate Highway 35 Ste 100
Austin, TX 78744-7901
Phone
(512) 735-6300
Fax
(512) 292-1465
NPI assigned
May 4, 2020
Organization subpart
No

Authorized official

Name
Thomas L. Weinberg
Title
Authorized Official - President/Cha
Phone
(214) 736-2700

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 10

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2076611Wellbound of South Austin
9811 South Interstate Highway 35,Building 4, Austin, TX 78744
Certificate of waiverApr 22, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200707000101 TX Part a Provider - End-Stage Renal Disease Facility (ESRD) 0840611646 Practice locations: Austin, TX

National Provider Directory

Tax ID family
Satellite Healthcare of Austin LLC (11 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Yes

Addresses

Primary practice location

9811 S Interstate Highway 35 Ste 100
Austin, TX 78744-7901

Mailing address

300 Santana Row Ste 300
San Jose, CA 95128-2424
Phone (650) 404-3655

Other identifiers

IdentifierTypeStateIssuer
110578OtherTXSTATE LICENSE

Other names

  • Satellite WellBound South Austin Doing business as

Other providers in Austin, TX

All providers in Austin, TX · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.