NPIMap

Organization Active NPI

Satellite Healthcare Inc

Doing business as WellBound of Santa Cruz

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Santa Cruz, CA
National Provider Identifier
1669741468
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
Legal business name
SATELLITE HEALTHCARE INC
Doing business as
WellBound of Santa Cruz
Practice address
2128 Soquel Ave
Santa Cruz, CA 95062-1401
Phone
(831) 425-0727
Fax
(831) 425-3731
NPI assigned
Dec 22, 2011
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

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 NU Primary

Addresses

Primary practice location

2128 Soquel Ave
Santa Cruz, CA 95062-1401

Mailing address

300 Santana Row
Suite 300
San Jose, CA 95128-2423
Phone (831) 600-4840

Other identifiers 1

IdentifierTypeStateIssuer
1669741468MedicaidCA

Other names 1

  • WellBound of Santa Cruz Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160407000874 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2668389529 Practice locations: Santa Cruz, 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.

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1669741468",
    "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": "831-600-4840",
            "fax_number": "650-625-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621401",
            "telephone_number": "831-425-0727",
            "fax_number": "831-425-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669741468",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellBound of Santa Cruz",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellBound of Santa Cruz",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Cruz, 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.
  • 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.