NPIMap

Organization Active NPI

Satellite Healthcare Inc

Doing business as Satellite Healthcare Folsom

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Folsom, CA
National Provider Identifier
1912446865
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
Satellite Healthcare Folsom
Practice address
210 Blue Ravine Rd Ste 100
Folsom, CA 95630-4795
Phone
(650) 404-3600
NPI assigned
Feb 13, 2017
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 Primary

Addresses

Primary practice location

210 Blue Ravine Rd Ste 100
Folsom, CA 95630-4795

Mailing address

300 Santana Row Ste 300
Suite 100
San Jose, CA 95128-2424
Phone (650) 404-3600

Other identifiers 1

IdentifierTypeStateIssuer
9912010751OtherCABUSINESS LICENSE

Other names 1

  • Satellite Healthcare Folsom Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170913003190 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 2668389529 Practice locations: Folsom, 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 Laboratory SE8 organizations share this tax ID, including this one
Part of
Satellite Laboratory SE

Other organizations with this tax ID 7

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

Locations

300 Santana Row
Ste 100
San Jose, CA 95128

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1912446865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SANTANA ROW STE 300",
            "address_2": "SUITE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282424",
            "telephone_number": "650-404-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BLUE RAVINE RD STE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304795",
            "telephone_number": "650-404-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATELLITE HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATELLITE HEALTHCARE INC",
        "enumeration_date": "2017-02-13",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "9912010751",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Satellite Healthcare Folsom",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Satellite Healthcare Folsom",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Folsom, 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.