Sue Pengsu Jiang

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A164280 Issued in CA

Practice address

11100 Euclid Ave
Cleveland, OH 44106-1716

Phone

(216) 844-1000

NPI assigned

Mar 21, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Centric Health Inc

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1265293393

  Single Specialty

  NPD Authorized official
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Pico Rivera, CA
  • NPI 1891287827
  NPD
• Carbon Health Medical Group of California PC

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232

  Single Specialty

  NPD (past)
• The Regents of the University of California-Irvine

  • Hospitalist Physician
  • Orange, CA
  • NPI 1154479723

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1013411248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13047 ARTESIA BLVD STE B200",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 The City Dr S Ste 400",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683201",
            "country_code": "US",
            "telephone_number": "714-456-5691",
            "fax_number": "714-456-8874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIANG",
        "first_name": "SUE",
        "middle_name": "PENGSU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-05-07",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A164280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ailin Jiang, DNP, CRNA
• Boxiang Jiang
• Judy Jiang, MD
• Matthew Yu Jiang, MD
• Michael Xing Jiang, MD
• Xiaolei Jiang, CNP
• Yutian Jiang
• Gaoliang Jiao, DO
• Stephanie Ann Jickess, MS, OTR/L
• Vicente Federico Jimenez Llovera, MD

• Internal Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.