Individual provider Active NPI

William Su, MD

  • Anesthesiology Physician
  • Randallstown, MD
National Provider Identifier
1972647212
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0064125 Issued in MD
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 521-2200
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0064125 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

11781 Lee Jackson Memorial Hwy
Suite 550
Fairfax, VA 22033-3309
Phone (571) 777-5157

Other identifiers 3

IdentifierTypeStateIssuer
1720024235OtherMDTYPE II GROUP NPI
191502900MedicaidMD
C11298OtherMDRAILROAD MEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20070525000326 MD Practitioner - Anesthesiology 4587761523 Reassigns benefits to 5 organizations
I20151209000075 DC Practitioner - Anesthesiology 4587761523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Hahnemann University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

1300 York Rd
Suite 200
Timonium, MD 21093-6090
Phone (410) 960-2686

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone 80051653155104

Hospital & facility affiliations

  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040
  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0064125MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Maryland LLC Anesthesiology CurrentSince Oct 1, 2015 Accepting new patients
Apex Anesthesia LLC Anesthesiology CurrentSince Dec 7, 2020 Accepting new patients
Global Anesthesia Services LLC Anesthesiology CurrentSince Feb 1, 2015 Accepting new patients
Francu One LLC CurrentSince Feb 19, 2013 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

626C Admiral Dr
#324
Annapolis, MD 21401

2401 W Belvedere Ave
Baltimore, MD 21215

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

9001 Woodyard Rd
Ste B
Clinton, MD 20735
Phone (301) 868-4950

10700 Charter Dr
Ste 301
Columbia, MD 21044
Phone (410) 730-0099

6816 Deerpath Rd
Elkridge, MD 21075
Phone (410) 757-5019

308 Hospital Dr
Ste 102
Glen Burnie, MD 21061
Phone (410) 760-8100

4132 E Joppa Rd
Ste 110
Nottingham, MD 21236
Phone (410) 205-5496

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

1300 York Rd
Ste 200
Timonium, MD 21093
Phone (410) 583-9675

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1972647212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMORIAL HWY",
            "address_2": "SUITE 550",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "571-777-5157",
            "fax_number": "703-890-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0064125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II GROUP NPI",
            "identifier": "1720024235",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191502900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "C11298",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.