Satellite Dialysis of South Stockton LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SATELLITE DIALYSIS OF SOUTH STOCKTON LLC

Doing business as

Satellite Healthcare University Park

Practice address

590 E Harding Wy
Stockton, CA 95204-6110

Phone

(209) 774-5800

Fax

(209) 462-2118

NPI assigned

Feb 27, 2012

Organization subpart

Yes

Parent organization

SATELLITE HEALTHCARE INCAs reported in NPPES

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

Authorized official

Name

Thomas L Weinberg

Title

Chairman

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Satellite Healthcare University Park Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

SHC University ParkCCN 552704

Overall star rating

3.0 of 5

Ownership

Non-profit

Certified

Nov 8, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

25

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

CLIA laboratory certificates

Part of

Satellite Laboratory SE

Member of 1

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

• Satellite Healthcare Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jamestown, CA
  • NPI 1649241720

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sydney Urbina, RD

  • Renal Nutrition Registered Dietitian
  • Stockton, CA
  • NPI 1356686471
  NPD (past)

Affiliated clinicians 2

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

• Randeep Singh Bajwa, MD

  • Nephrology Physician
  • Stockton, CA
  • NPI 1083611594

  Dialysis facility

  Care Compare affiliation Name & address match
• Shivjitinder Sidhu, M.D.

  • Nephrology Physician
  • Stockton, CA
  • NPI 1841549607

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1104190826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SANTANA ROW",
            "address_2": "SUITE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282423",
            "telephone_number": "209-774-5800",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 E HARDING WY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046110",
            "telephone_number": "209-774-5800",
            "fax_number": "209-462-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE DIALYSIS OF SOUTH STOCKTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATELLITE HEALTHCARE INC",
        "enumeration_date": "2012-02-27",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104190826",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "550002047",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satellite Healthcare University Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Satellite Healthcare University Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsay T Sasaki
• Sasha Jackson, LLC
• Janiece Sasser
• Irene Satake
• Anne-Marie Satariano, COTA
• Satellite Dialysis of Stockton LLC
• Bindu Kanathezhath Sathi, M.D.
• Katie Ann Draper Satterfield
• Satya Sol Family Wellness
• Derek Michael Sauceda, CATC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Stockton, CA
• Providers in Stockton, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.