Individual provider Active NPI

Jin Wen Sui, MD

  • Trauma Surgery Physician
  • Santa Ana, CA
National Provider Identifier
1114411352
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
A165749 Issued in CA
Practice address
999 N Tustin Ave Ste 109
Santa Ana, CA 92705-6501
Phone
(714) 954-1182
Fax
(714) 953-3425
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0127X A165749 CA Primary

Addresses

Primary practice location

999 N Tustin Ave Ste 109
Santa Ana, CA 92705-6501

Mailing address

PO Box 3428
Tustin, CA 92781-3428

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241004001892 CA Practitioner - General Surgery 5395146906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange County Emergency Surgical Specialists, IncGroup PAC ID 1355410754, 5 clinicians
Western Medical Center Trauma Group IncGroup PAC ID 9739120551, 6 clinicians

Practice addresses (Care Compare)

999 N Tustin Ave
Suite 109
Santa Ana, CA 92705-6501
Phone (714) 954-1182

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Coronary artery bypass graft (CABG)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A165749CAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Emergency Surgical Specialists, Inc Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Western Medical Center Trauma Group Inc Single Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

999 N Tustin Ave
Ste 109
Santa Ana, CA 92705
Phone (714) 664-0045

Interoperability endpoints

  • Direct secure messaging: jsui419567@direct.cshs.org

Organizations & group practices 2

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 1

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1114411352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927813428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE STE 109",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056501",
            "telephone_number": "714-954-1182",
            "fax_number": "714-953-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUI",
        "first_name": "JIN",
        "middle_name": "WEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A165749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.