Daniel L Su, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00038293 Issued in WA

Practice address

436 Ted Stevens Way
Maniilaq Health Center
Kotzebue, AK 99752

Phone

(907) 442-7148

Fax

(907) 442-7306

NPI assigned

Feb 19, 2007

Last updated

Dec 8, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, WA2 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

Family Practice

Education

University of Washington School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

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.

• Lummi Indian Business Council

  dba Lummi Nation Health Center

  • Clinic/Center
  • Bellingham, WA
  • NPI 1669592374
  Medicare reassignment Care Compare group NPD
• Maniilaq Association

  dba Maniilaq Health Center

  • Rural Acute Care Hospital
  • Kotzebue, AK
  • NPI 1861698805

  TX

  Medicare reassignment NPD
• Maniilaq Association

  dba Maniilaq Health Center

  • Critical Access Hospital
  • Kotzebue, AK
  • NPI 1316995210
  Medicare reassignment
• Lummi Indian Business Council

  dba Lummi Nation Health Center

  • Counselor
  • Bellingham, WA
  • NPI 1225158769
  NPD

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1811031156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 H ST # 909",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982304018",
            "telephone_number": "360-223-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 TED STEVENS WAY",
            "address_2": "MANIILAQ HEALTH CENTER",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "99752",
            "telephone_number": "907-442-7148",
            "fax_number": "907-442-7306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00038293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8254518",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles R Stoner, LPN
• Tammy R Stoner
• Mark Conrad Stover, MD
• Erica Louise Strandlie
• Amelia Stutman
• Kirsten Sundeen, LCSW-C
• Ida Swan
• Joseph Swan III
• Sherry Swan
• Blanche Myrtle Swanson

• Family Medicine Physician in Kotzebue, AK
• Providers in Kotzebue, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.