NPIMap

Individual provider Active NPI

Teddy Su, MD

  • Diagnostic Radiology Physician
  • Travis Afb, CA
National Provider Identifier
1003881830
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
105730 Issued in CA
Practice address
101 Bodin Cir
60TH Medical Group
Travis Afb, CA 94535-1809
Phone
(707) 423-7181
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 105730 CA Primary

Addresses

Primary practice location

101 Bodin Cir
60TH Medical Group
Travis Afb, CA 94535-1809

Mailing address

40087 Mission Blvd # 250
Fremont, CA 94539-3680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000765 CA Practitioner - Diagnostic Radiology 5991802860 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

6955 Foothill Blvd
Suite 200
Oakland, CA 94605-2426
Phone (510) 567-5704

Hospital & facility affiliations

  • Highland Hospital Hospital, Oakland, CA, CCN 050320
  • Alameda Hospital Hospital, Alameda, CA, CCN 050211
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
105730CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince May 31, 2020 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 22, 2019 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince May 1, 2015 Accepting new patients
Sutter Valley Medical Foundation Diagnostic Radiology Current Accepting new patients
Alameda Health System CurrentSince May 31, 2020 Accepting new patients
Regents of the University of California Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Brigham and Womens Physicians Organization Inc Diagnostic Radiology Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Alameda Health System Past Accepting new patients
Twin Cities Surgical Hospital LLC Past Accepting new patients

Locations

815 Atlantic Ave
Ste 100
Alameda, CA 94501
Phone (510) 522-6637

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

6066 Civic Terrace Ave
Newark, CA 94560
Phone (510) 505-1600

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

Interoperability endpoints

  • Direct secure messaging: tsu14579@alamedahs.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1003881830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40087 MISSION BLVD # 250",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945393680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60TH MEDICAL GROUP",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "TEDDY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "105730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.