Organization Active NPI

Satellite Santa Rosa, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1053198812
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SATELLITE SANTA ROSA, LLC
Practice address
2301 Circadian Way Ste C
Santa Rosa, CA 95407-5457
Phone
(707) 526-0717
Fax
(707) 526-0722
NPI assigned
Sep 13, 2023
Last updated
Sep 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
U.S. RENAL CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Authorized official

Name
Thomas L. Weinberg
Title
President & Chairman
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

2301 Circadian Way Ste C
Santa Rosa, CA 95407-5457

Mailing address

5851 Legacy Cir Ste 900
Plano, TX 75024-5982
Phone (214) 736-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231106002308 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 6305293853 Practice locations: Santa Rosa, CA

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1053198812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 LEGACY CIR STE 900",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750245982",
            "telephone_number": "214-736-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 CIRCADIAN WAY STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075457",
            "telephone_number": "707-526-0717",
            "fax_number": "707-526-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE SANTA ROSA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.