Simon Yongquan Su, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD065401Y Issued in PA

Practice address

109 N 9TH St
Philadelphia, PA 19107-2410

Phone

(215) 923-2810

Fax

(215) 923-2925

NPI assigned

Jan 11, 2006

Last updated

Apr 19, 2011By the provider in NPPES

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

Other identifiers 1

Other names 1

• Yongquan Su Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Internal Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• E H Managment Company , Inc

  • Diagnostic Radiology Physician
  • Philadelphia, PA
  • NPI 1487895918
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1346229044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072410",
            "telephone_number": "215-923-2810",
            "fax_number": "215-923-2925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072410",
            "telephone_number": "215-923-2810",
            "fax_number": "215-923-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "SIMON YONGQUAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD065401Y",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01733013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YONGQUAN",
            "last_name": "SU",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Henry H. Su, D.O.
• Isaac E Su, MD
• Laura Su, MD. PHD.
• Lisa Su, MD
• Michelle Su, PA-C
• Stacey Su, MD
• Vinh Su, PHARMD
• Chintana Suanlarm, MD
• Adolfo Suarez, MA
• Allison Suarez

• Internal Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.