NPIMap

Individual provider Active NPI

Andres Su, M.D.

  • Internal Medicine Physician
  • Dorchester, MA
National Provider Identifier
1194164624
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
255449 Issued in MA
Practice address
2100 Dorchester Ave
Dorchester, MA 02124-5615
Phone
(617) 296-4000
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255449 MA Primary
Diagnostic Radiology Physician 2085R0202X 83546 GA

Addresses

Primary practice location

2100 Dorchester Ave
Dorchester, MA 02124-5615

Mailing address

1 Aberdeen Way
Suite 126
Cambridge, MA 02138-4626
Phone (646) 662-7534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190828004213 GA Practitioner - Diagnostic Radiology 2365792942 Reassigns benefits to 3 organizations
I20260411000180 NJ Practitioner - Diagnostic Radiology 2365792942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

213 Adams St
Decatur, GA 30030-5203
Phone (610) 868-1100

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Luke'S Hospital - Carbon Campus Hospital, Lehighton, PA, CCN 390335
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255449MAMDInternal Medicine Physician
83546GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Internal Medicine Current Accepting new patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Emory Medical Care Foundation Inc Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
Pontchartrain Diagnostic Imaging LLC Diagnostic Radiology Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

1736 Hamilton St
Allentown, PA 18104
Phone (610) 770-8300

Organizations & group practices 5

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 10

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1194164624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ABERDEEN WAY",
            "address_2": "SUITE 126",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384626",
            "telephone_number": "646-662-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "ANDRES",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "255449",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "83546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.