Active NPI
Lisa Su, MD
- Orthopaedic Surgery Physician
- La Jolla, CA
National Provider Identifier
1417536806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- A184957
- Practice address
- 10710 N Torrey Pines Rd
La Jolla, CA 92037-1035 - Phone
- (858) 554-7993
- NPI assigned
- Apr 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | A184957 | CA | |
| Orthopaedic Surgery Physician | 207X00000X | A184957 | CA | Primary |
Addresses
Primary practice location
10710 N Torrey Pines Rd
La Jolla, CA 92037-1035
Mailing address
10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 554-7993
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220328001654 | CA | Order and Referring Only - Orthopedic Surgery | 3577958636 |
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of California, Geffen School of Medicine, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
12130 Ohio Ave
Apt 303
Los Angeles, CA 90025-2564
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782950400000",
"number": "1417536806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10790 RANCHO BERNARDO RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921275705",
"telephone_number": "858-554-7993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10710 N TORREY PINES RD",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371035",
"telephone_number": "858-554-7993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "LISA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-05",
"last_updated": "2026-07-02",
"certification_date": "2026-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "CA",
"license": "A184957",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A184957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.