Organization Active NPI

Satellite Healthcare Vallejo, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Vallejo, CA
National Provider Identifier
1124805908
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 HEALTHCARE VALLEJO, LLC
Practice address
4300 Sonoma Blvd Ste 25
Vallejo, CA 94589-2276
Phone
(707) 561-7150
Fax
(707) 554-4487
NPI assigned
Sep 13, 2023
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
Chairman & President
Phone
(214) 736-2700

Specialties & licenses 1

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

Addresses

Primary practice location

4300 Sonoma Blvd Ste 25
Vallejo, CA 94589-2276

Mailing address

5851 Legacy Cir Ste 900
Plano, TX 75024-5982

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231116003229 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2961859699 Practice locations: Vallejo, CA

National Provider Directory

National Provider Directory
Part of
US Renal Care Inc

Locations

4300 Sonoma Blvd
Ste 25
Vallejo, CA 94589
Phone (707) 561-7150

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": "1124805908",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 SONOMA BLVD STE 25",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892276",
            "telephone_number": "707-561-7150",
            "fax_number": "707-554-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE HEALTHCARE VALLEJO, 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": "CHAIRMAN & PRESIDENT",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, 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.