Su Luo, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD15425 Issued in RI

Practice address

750 Reservoir Ave
Cranston, RI 02910-4423

Phone

(401) 943-0761

NPI assigned

Apr 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

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 2

Specialty

Dermatology

Education

University of Miami, LM Miller School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Derm and Cosmetic Center, IncGroup PAC ID 6709004484, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Derm & Cosmetic Center, Inc

  • Dermatology Physician
  • Cranston, RI
  • NPI 1528487683
  Medicare reassignment Care Compare group
• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1609165315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BELLE ISLE WAY",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029213542",
            "telephone_number": "401-527-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104423",
            "telephone_number": "401-943-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "SU",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "MD15425",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "RI",
            "license": "MD15425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE 855O",
            "identifier": "207N00000X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Louis, BACHELORS
• Tanille Leana Louis, MS, PHMNP-BC
• Julia Loup
• Donald William Lovejoy, CDP
• Densie Lowell, MASTERS
• Cierra Nicole Lussier, M.S., CCC-SLP
• Sivhour Ly, OD
• Richard Thad Lyon, D.C.
• Anthony Mabray
• Katherine Louise Mac Lean, MD

• MOHS-Micrographic Surgery Physician in Cranston, RI
• Providers in Cranston, RI by specialty
• MOHS-Micrographic Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.

Verify at the official NPI Registry.