Individual provider Active NPI

Brian Su, MD

  • Orthopaedic Surgery of the Spine Physician
  • Larkspur, CA
National Provider Identifier
1063690782
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A109113 Issued in CA
Practice address
2 Bon Air Rd
Suite 120
Larkspur, CA 94939-1141
Phone
(415) 925-8200
Fax
(415) 464-5480
NPI assigned
Feb 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 237395 NY
Orthopaedic Surgery of the Spine Physician 207XS0117X A109113 CA Primary

Addresses

Primary practice location

2 Bon Air Rd
Suite 120
Larkspur, CA 94939-1141

Mailing address

2 Bon Air Rd
Suite 120
Larkspur, CA 94939-1141
Phone (415) 925-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091014000397 CA Practitioner - General SurgeryPractitioner - Orthopedic Surgery 3577609056
I20230905001260 CA Practitioner - Orthopedic Surgery 3577609056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Columbia University College of Physicians and Surgeons, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Regents Univ of California UCSFGroup PAC ID 6305160300, 276 clinicians

Practice addresses (Care Compare)

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.03 of 100Reported as subgroup
Quality
80.86
Promoting interoperability
76
Improvement activities
40
Cost
75.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion241
Laminectomy or laminotomy (partial removal of spine bones)99

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A109113CAMDOrthopaedic Surgery of the Spine Physician
237395NYMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Orthopedics & Spine Inc CurrentSince Sep 1, 2009 Accepting new patients
Regents Univ of California UCSF CurrentSince Jul 27, 2023 Accepting new patients
California Orthopedics & Spine Inc Current Accepting new patients
California Orthopedics & Spine Inc CurrentSince Sep 1, 2009 Accepting new patients

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

18 Bon Air Rd
Larkspur, CA 94939
Phone (415) 927-5300

2 Bon Air Rd
Ste 120
Larkspur, CA 94939
Phone (415) 496-2812

2 Bon Air Rd
Ste 120A
Larkspur, CA 94939
Phone (415) 496-2812

7100 Redwood Blvd
Ste 200
Novato, CA 94945
Phone (415) 492-1600

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bsu223508@direct-ucsfmedicalcenter.org
  • Direct secure messaging: bsu585313@direct.ochin.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marinhealth Medical CenterGreenbrae, CA, CCN 05S360 Hospital Corporate Director Jan 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1063690782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BON AIR RD",
            "address_2": "SUITE 120",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391141",
            "telephone_number": "415-925-8200",
            "fax_number": "415-464-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BON AIR RD",
            "address_2": "SUITE 120",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391141",
            "telephone_number": "415-925-8200",
            "fax_number": "415-464-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-05",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NY",
            "license": "237395",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A109113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larkspur, CA

Sources for this page

Verify at the official NPI Registry.