Active NPI
Satellite Healthcare of San Carlos, LLC
Doing business as Satellite Healthcare San Carlos
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Carlos, CA
National Provider Identifier
1386615458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 140000628
- Legal business name
- SATELLITE HEALTHCARE OF SAN CARLOS, LLC
- Doing business as
- Satellite Healthcare San Carlos
- Practice address
- 1125 Industrial Road
Suite G
San Carlos, CA 94070-4159 - Phone
- (650) 366-0789
- Fax
- (650) 366-0553
- NPI assigned
- Jan 27, 2006
- Last updated
- May 15, 2024
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 140000628 | CA | Primary |
Addresses
Primary practice location
1125 Industrial Road
Suite G
San Carlos, CA 94070-4159
Mailing address
300 Santana Row
Ste 300
San Jose, CA 95128-2423
Phone (650) 366-0789
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140000628 | Other | CA | STATE OF CALIFORNIA |
| CDC02793F | Medicaid | CA |
Other names 1
- Satellite Healthcare San Carlos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170310001792 | CA | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 8628352663 | Practice locations: San Carlos, CA |
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- SHC San Carlos
- Overall star rating
- Ownership
- Non-profit
- Certified
- Jul 25, 1996
- Medicare certification status
- Active
- Chain
- US Renal Care, Inc.
- Dialysis stations
- 23
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0918754 | Satellite Healthcare San Carlos | Certificate of waiver | Aug 19, 2026 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Satellite Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Mateo, CA
- NPI 1730110578
Member Of
Practitioners & affiliated clinicians
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Nephrology Physician
- Daly City, CA
- NPI 1245235738
Dialysis facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715731200000",
"number": "1386615458",
"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": "650-366-0789",
"fax_number": "650-625-6007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 INDUSTRIAL ROAD",
"address_2": "SUITE G",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940704159",
"telephone_number": "650-366-0789",
"fax_number": "650-366-0553"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SATELLITE HEALTHCARE OF SAN CARLOS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-27",
"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": "CA",
"license": "140000628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA",
"identifier": "140000628",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CDC02793F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Satellite Healthcare San Carlos",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Satellite Healthcare San Carlos",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Carlos, CA
Sources for this page
- 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.