Organization Active NPI

Satellite Healthcare Inc

Doing business as Satellite Healthcare Stevens Creek

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cupertino, CA
National Provider Identifier
1386615235
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
140000633 Issued in CA
Legal business name
SATELLITE HEALTHCARE INC
Doing business as
Satellite Healthcare Stevens Creek
Practice address
4360 Stevens Creek Boulevard
Suite a
Cupertino, CA 95014-0708
Phone
(408) 517-5777
Fax
(408) 517-5785
NPI assigned
Jan 30, 2006
Organization subpart
Yes
Parent organization
SATELLITE HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 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 140000633 CA Primary

Addresses

Primary practice location

4360 Stevens Creek Boulevard
Suite a
Cupertino, CA 95014-0708

Mailing address

300 Santana Row
Ste 300
San Jose, CA 95128-2423
Phone (408) 517-5777

Other identifiers 2

IdentifierTypeStateIssuer
ZZR02514FMedicaidCA
140000633OtherCASTATE OF CALIFORNIA

Other names 1

  • Satellite Healthcare Stevens Creek Doing business as

National Provider Directory

National Provider Directory
Part of
Satellite Laboratory SE

Locations

4360 Stevens Creek Blvd
#A
San Jose, CA 95129
Phone (408) 517-5777

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1386615235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SANTANA ROW",
            "address_2": "STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282423",
            "telephone_number": "408-517-5777",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 STEVENS CREEK BOULEVARD",
            "address_2": "SUITE A",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140708",
            "telephone_number": "408-517-5777",
            "fax_number": "408-517-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATELLITE HEALTHCARE INC",
        "enumeration_date": "2006-01-30",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "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": "CA",
            "license": "140000633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR02514F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "140000633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satellite Healthcare Stevens Creek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Satellite Healthcare Stevens Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cupertino, CA

Sources for this page

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

Verify at the official NPI Registry.