NPIMap

Individual provider Active NPI

Jialin Su

  • Clinical Cardiac Electrophysiology Physician
  • Jacksonville, FL
National Provider Identifier
1740593821
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
ME134322 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209
Phone
(904) 383-1011
Fax
(904) 244-5913
NPI assigned
Jul 19, 2010
Last updated
May 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X ME134322 FL
Cardiovascular Disease Physician 207RC0000X ME134322 FL
Clinical Cardiac Electrophysiology Physician 207RC0001X ME134322 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 383-1011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210823001320 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 2567682149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

3300 Main St
Springfield, MA 01107-1112
Phone (413) 794-7246

777 N Street 4TH Floor
Cardiology Professional Services of BMC
Pittsfield, MA 01201-4147
Phone (413) 395-7580

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME134322FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Internal Medicine Current Accepting new patients
Baystate Medical Practices, Inc Internal Medicine CurrentSince Nov 16, 2021 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Aug 2, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 1, 2017 Accepting new patients
University of Florida Jacksonville Physicians Inc Cardiovascular Disease CurrentSince Nov 1, 2017 Accepting new patients
Fairview Hospital CurrentSince Aug 2, 2021 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

3300 Main St
Springfield, MA 01107
Phone (413) 794-7031

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

Interoperability endpoints

  • Direct secure messaging: jialinsu@bfs.medalliesdirect.net

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

Hospital & facility affiliations 5

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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1740593821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-383-1011",
            "fax_number": "904-244-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-383-1011",
            "fax_number": "904-244-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "JIALIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME134322",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME134322",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME134322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.