SHADELANDS ENDOVASCULAR, LLC
NPI 1245620954
Clinic/Center - Ambulatory Surgical in Walnut Creek, CA
NPI Status: Active since February 02, 2015
Contact Information
460 N WIGET LN STE B
WALNUT CREEK, CA
ZIP 94598
Phone: (925) 627-3495
Fax: (925) 891-4322
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 05D2116202
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 07-20-2026
About SHADELANDS ENDOVASCULAR, LLC
This page provides the complete NPI Profile along with additional information for Shadelands Endovascular, Llc, a provider established in Walnut Creek, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1245620954 assigned on February 2015. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Inez Wondeh (Coo)
- NPI
- 1245620954
- Provider Name
- SHADELANDS ENDOVASCULAR, LLC
- Entity Type
- Organization
- Location Address
- 460 N WIGET LN STE B WALNUT CREEK, CA 94598
- Location Phone
- (925) 627-3495
- Location Fax
- (925) 891-4322
- Mailing Address
- 460 N WIGET LN STE B WALNUT CREEK, CA 94598
- Mailing Phone
- (925) 627-3495
- Mailing Fax
- (925) 891-4322
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-02-2015
- Last Update Date
- 04-04-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist
Removal of plaque in arteries of leg
This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.
This service was performed 115 times for 94 patientsThis procedure, known as atherectomy, involves clearing out plaque buildup in the leg arteries. Plaque can restrict blood flow, causing discomfort and potential health issues. A special device is inserted into the artery to carefully remove the plaque, improving blood circulation.
This service was performed 16 times for 15 patientsCLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2116202
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- July 21, 2024
- Certificate Expiration Date
- July 20, 2026
- Laboratory Director
- FERNANDO OTERO, MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Shadelands Endovascular, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1245620954, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245620954, enumerated as an "organization" on February 02, 2015.
The provider is located at 460 N WIGET LN STE B WALNUT CREEK, CA 94598 and the phone number is (925) 627-3495.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
