Individual provider Active NPI

Ruthie Su, MD

  • Pediatric Urology Physician
  • Little Rock, AR
National Provider Identifier
1952544793
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
License
E17173 Issued in AR
Practice address
1 Childrens Way
Little Rock, AR 72202-3500
Phone
(501) 364-2090
Fax
(501) 364-3929
NPI assigned
Apr 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 60839 WI
Pediatric Urology Physician 2088P0231X 60839 WI
Pediatric Urology Physician 2088P0231X E17173 AR Primary

Addresses

Primary practice location

1 Childrens Way
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 844
Little Rock, AR 72202-3500
Phone (501) 364-2090

Other practice location 1

137 E Wilson St Unit 710
Madison, WI 53703-4080
Phone (559) 360-5666

Other practice location 2

2601 Gene George Blvd
Springdale, AR 72762-0845
Phone (501) 364-2090

Other identifiers 3

IdentifierTypeStateIssuer
201200200AMedicaidOK
200132676MedicaidMO
311524001MedicaidAR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address rsu681212@direct.uwhealth.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address rsu169792@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, AR2 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

Enrollment IDStateProvider typePAC IDDetails
I20130715000682 WI Practitioner - Urology 5294981692
I20231120000729 AR Practitioner - UrologyPractitioner - Pediatric Medicine 5294981692 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60839WIMDUrology Physician
E17173ARMDPediatric Urology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children's Medical Group PLLC CurrentSince Oct 6, 2023 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#844
Little Rock, AR 72202
Phone (501) 364-2090

900 S 52nd St
Rogers, AR 72758
Phone (501) 364-2090

2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800

1160 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-5400

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

Interoperability endpoints

  • Direct secure messaging: rsu681212@direct.uwhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1952544793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 844",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2090",
            "fax_number": "501-364-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-2090",
            "fax_number": "501-364-3929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 E Wilson St Unit 710",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537034080",
            "country_code": "US",
            "telephone_number": "559-360-5666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 Gene George Blvd",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727620845",
            "country_code": "US",
            "telephone_number": "501-364-2090",
            "fax_number": "501-364-3929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "RUTHIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "60839",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "WI",
            "license": "60839",
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "AR",
            "license": "E17173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201200200A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200132676",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311524001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsu681212@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsu169792@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 Highland Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537920002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.