Individual provider Active NPI

Terry Su, M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Orlando, FL
National Provider Identifier
1205164878
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
ME110177 Issued in FL
Practice address
7350 Sandlake Commons Blvd Ste 2212a
Orlando, FL 32819-8031
Phone
(407) 463-9588
Fax
(949) 798-7844
NPI assigned
Nov 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X ME110177 FL Primary

Addresses

Primary practice location

7350 Sandlake Commons Blvd Ste 2212a
Orlando, FL 32819-8031

Mailing address

PO Box 1112
Windermere, FL 34786-1112
Phone (407) 463-9588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110727000610 FL Practitioner - Maxillofacial Surgery 1456529908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Un of California, Irvine, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7350 Sandlake Commons Blvd
Suite 2212a
Orlando, FL 32819-8031
Phone (407) 913-5027

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Maxillofacial and Reconstructive Surgery PA Oral & Maxillofacial Surgery CurrentSince May 14, 2022 Accepting new patients

Locations

7350 Sandlake Commons Blvd
Ste 2225A
Orlando, FL 32819
Phone (407) 913-5027

7350 Sandlake Commons Blvd
Ste 2212A
Orlando, FL 32819
Phone (407) 463-9588

Interoperability endpoints

  • Direct secure messaging: terry.su@hca4.eclinicaldirectplus.com

Organizations & group practices 1

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 4

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": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1205164878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1112",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347861112",
            "telephone_number": "407-463-9588",
            "fax_number": "949-798-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 SANDLAKE COMMONS BLVD STE 2212A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198031",
            "telephone_number": "407-463-9588",
            "fax_number": "949-798-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "TERRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME110177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.