NPIMap

Individual provider Active NPI

Jeannie Jiwon Su, M.D.

  • Urology Physician
  • Santa Monica, CA
National Provider Identifier
1922487800
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A168007 Issued in CA
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone
(310) 582-7137
NPI assigned
May 25, 2015
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A168007 CA Primary

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Mailing address

1014 Broadway # 109
Santa Monica, CA 90401-2808
Phone (424) 432-2304

Other practice location 1

8631 W 3rd St Ste 1115E
Los Angeles, CA 90048-5901
Phone (310) 278-8330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200611001972 CA Practitioner - Urology 4385956465 Reassigns benefits to 5 organizations
I20230124000565 TX Practitioner - Urology 4385956465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Signature Medical Clinics IncGroup PAC ID 1759493216, 8 clinicians
Comprehensive Urology Medical GroupGroup PAC ID 8224067145, 6 clinicians

Practice addresses (Care Compare)

1127 Wilshire Blvd
Suite 1618
Los Angeles, CA 90017-4007
Phone (213) 977-1176

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (424) 432-2304

23845 McBean Pkwy
Valencia, CA 91355-2001
Phone (661) 253-8000

8 Medical Pkwy
Suite 305
Farmers Branch, TX 75234-7843
Phone (310) 806-4451

8631 W 3Rd St
Los Angeles, CA 90048-5901
Phone (310) 278-8330

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168007CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
S. Adam Ramin MD Inc Single Specialty Current Accepting new patients
Su Medical Group, PC Single Specialty Current Accepting new patients
Jsu Medical, PC Single Specialty CurrentSince Jul 5, 2023 Accepting new patients
Comprehensive Urology Medical Group Single Specialty CurrentSince Jul 25, 2021 Accepting new patients
Providence Saint Johns Medical Foundation Single Specialty CurrentSince Jun 1, 2020 Accepting new patients
Henry Mayo Newhall Memorial Hospital Single Specialty CurrentSince Apr 28, 2025 Accepting new patients
Signature Medical Clinics Inc Single Specialty CurrentSince Sep 1, 2023 Accepting new patients
Hillstone Medical Group Inc Past Accepting new patients
Providence Saint John's Health Center Single Specialty Past Accepting new patients
Saint John's Health Clinic Single Specialty Past Accepting new patients
Planned Parenthood of Greater New York Inc Single Specialty Past Accepting new patients
Comprehensive Urology Medical Group Single Specialty Past Accepting new patients

Locations

1127 Wilshire Blvd
Ste 1618
Los Angeles, CA 90017
Phone (213) 482-3467

400 W 30th St
Los Angeles, CA 90007
Phone (213) 284-3200

8631 W 3rd St
Ste 1115E
Los Angeles, CA 90048
Phone (310) 278-8330

1014 Broadway
Santa Monica, CA 90401

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

23845 McBean Pkwy
Valencia, CA 91355
Phone (661) 200-2000

8 Medical Pkwy
Ste 305
Farmers Branch, TX 75234
Phone (310) 806-4451

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jeannie.sumd.p1@direct.plannedparenthoodla.nextgenshare.com
  • Direct secure messaging: jsu@ugsc.emadirect.md
  • Direct secure messaging: jsu1252444@oc.providencedirect.org
  • Direct secure messaging: jsu157543@direct.ynhh.org
  • Direct secure messaging: jsu904182@direct.memorialcare.org

Organizations & group practices 12

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 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": "1432512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1922487800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 BROADWAY # 109",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012808",
            "telephone_number": "424-432-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-582-7137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8631 W 3rd St Ste 1115E",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485901",
            "country_code": "US",
            "telephone_number": "310-278-8330",
            "fax_number": "310-278-7595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "JEANNIE",
        "middle_name": "JIWON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-25",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A168007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.