Individual provider Active NPI

Jing Su

  • Family Nurse Practitioner
  • Federal Way, WA
National Provider Identifier
1871985077
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60514075 Issued in WA
Practice address
33501 1St Way S
Ms:a-So
Federal Way, WA 98003-6208
Phone
(253) 838-2400
Fax
(243) 874-1637
NPI assigned
Feb 24, 2015
Last updated
Sep 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60514075 WA Primary

Addresses

Primary practice location

33501 1St Way S
Ms:a-So
Federal Way, WA 98003-6208

Mailing address

33501 1St Way S
Ms:a-So
Federal Way, WA 98003-6208
Phone (253) 838-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104000477 WA Practitioner - Nurse Practitioner 7113229485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Jan 3, 2023 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center CurrentSince Jan 3, 2023 Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

19116 33rd Ave W
Lynnwood, WA 98036
Phone (425) 712-7900

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/

Organizations & group practices 4

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 1

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": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1871985077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33501 1ST WAY S",
            "address_2": "MS:A-SO",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036208",
            "telephone_number": "253-838-2400",
            "fax_number": "243-874-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33501 1ST WAY S",
            "address_2": "MS:A-SO",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036208",
            "telephone_number": "253-838-2400",
            "fax_number": "243-874-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "JING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60514075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.