NPIMap

Individual provider Active NPI

Yu-Kai Su

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1558775734
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A161950 Issued in CA
Practice address
757 Westwood PLZ Ste 1638
Los Angeles, CA 90095-2978
Phone
(310) 267-8796
Fax
(310) 267-2059
NPI assigned
Jun 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A161950 CA Primary

Addresses

Primary practice location

757 Westwood PLZ Ste 1638
Los Angeles, CA 90095-2978

Mailing address

5767 W Century Blvd Suite 400
Los Angeles, CA 90095-5631
Phone (310) 301-8707

Other practice location 1

1245 16th St Ste 105
Santa Monica, CA 90404-1239
Phone (310) 301-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190612000944 CA Practitioner - Diagnostic Radiology 1355687575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Valley Imaging Medical Group IncGroup PAC ID 6709898562, 22 clinicians

Practice addresses (Care Compare)

1798 N Garey Ave
Pomona, CA 91767-2918
Phone (909) 865-9535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A161950CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Imaging Medical Group Inc CurrentSince Jun 1, 2020 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 1, 2019 Accepting new patients
Martin Luther King Jr Community Medical Foundation Current Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Jul 1, 2019 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

Organizations & group practices 6

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 6

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1558775734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900955631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 1638",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952978",
            "telephone_number": "310-267-8796",
            "fax_number": "310-267-2059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 16th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041239",
            "country_code": "US",
            "telephone_number": "310-301-6800",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "YU-KAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A161950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.