Peter Su, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A170026 Issued in CA

Practice address

41540 Winchester Rd
Temecula, CA 92590-4877

Phone

(513) 655-5859

NPI assigned

Mar 22, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

24 On Physicians of California PCGroup PAC ID 7012228992, 58 clinicians

Emergency Physicians Urgent Care IncGroup PAC ID 8527234418, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uni Care Hospice Inc Hospice, Escondido, CA, CCN 751705
• Pioneers Memorial Healthcare District Hospital, Brawley, CA, CCN 050342
• El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

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.

• 24 On Physicians of California, PC

  • Hospitalist Physician
  • Porterville, CA
  • NPI 1730570565

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1689963845

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Providence Facey Medical Foundation

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588

  Single Specialty

  Medicare reassignment NPD
• Southern California Permanente Medical Group

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

  Single Specialty

  Medicare reassignment NPD
• Emergency Physicians Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1629442728
  NPD
• Providence Facey Medical Foundation

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• Providence Facey Medical Foundation

  • Urgent Care Clinic/Center
  • Santa Clarita, CA
  • NPI 1922651561
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1134151657

  Single Specialty

  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• El Centro Regional Medical Center

  • General Acute Care Hospital
  • El Centro, CA
  • NPI 1861409823
  Care Compare affiliation
• Imperial Valley Healthcare District

  • General Acute Care Hospital
  • Brawley, CA
  • NPI 1184429185
  Care Compare affiliation
• Uni Care Hospice, Inc

  • Inpatient Hospice
  • San Marcos, CA
  • NPI 1316358930
  Care Compare affiliation

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1225569205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 MONICA LN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927061335",
            "telephone_number": "268-638-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41540 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904877",
            "telephone_number": "513-655-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A170026",
            "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": "4760 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandra Nicole Strickland
• Amanda Strickland
• Taylor Leigh Striker
• Ryan Sturgis, CF-SLP
• Alvin Su, MD
• Kain Andrew Su'a, DC
• Sathish Subramanian, MD, PHD
• Realyn Suderman
• Adeline Sugeng
• Debbie Anne Suh, L.AC

• Family Medicine Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.