NPIMap

Organization Active NPI

Satellite Healthcare Inc

Doing business as Satellite Healthcare North Modesto

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Modesto, CA
National Provider Identifier
1154682441
Registry record updated Jan 11, 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 INC
Doing business as
Satellite Healthcare North Modesto
Practice address
4207 Bangs Ave
Suite 100
Modesto, CA 95356-8714
Phone
(209) 338-2500
Fax
(209) 543-3840
NPI assigned
Jun 3, 2012
Last updated
Jan 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Bernadette Vincent
Title
President/Coo
Phone
(650) 404-3600

Specialties & licenses 1

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

Addresses

Primary practice location

4207 Bangs Ave
Suite 100
Modesto, CA 95356-8714

Mailing address

300 Santana Row
Suite 300
San Jose, CA 95128-2424
Phone (209) 338-2500

Other identifiers 2

IdentifierTypeStateIssuer
1639511884MedicaidCA
550002626OtherCASTATE

Other names 1

  • Satellite Healthcare North Modesto Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130601000072 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2668389529 Practice locations: Modesto, CA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Satellite Dialysis CTRS Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1338681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1154682441",
    "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": "951282424",
            "telephone_number": "209-338-2500",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 BANGS AVE",
            "address_2": "SUITE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568714",
            "telephone_number": "209-338-2500",
            "fax_number": "209-543-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-03",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "PRESIDENT/COO",
        "authorized_official_telephone_number": "650-404-3600"
    },
    "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": "1639511884",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "550002626",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satellite Healthcare North Modesto",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Satellite Healthcare North Modesto",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.