Fannie Wyndy Su, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

A85919 Issued in CA

Practice address

130 La Casa Via
BLDG 2 Suite 209
Walnut Creek, CA 94598-3045

Phone

(925) 935-6252

NPI assigned

Mar 15, 2007

Sex

Female

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 CA

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 1

Specialty

Allergy/Immunology

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Allergy and Asthma Medical Group of the Bay Area IncGroup PAC ID 6507758224, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180

Merit-based Incentive Payment System (MIPS)

Final score

85.95 of 100Reported as group

Quality

99.17

Promoting interoperability

98

Improvement activities

40

Cost

55.67

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: fsu29448@ehr.johnmuirhealth.com

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.

• Allergy & Asthma Medical Group of the Bay Area Inc

  • Allergy & Immunology Physician
  • Walnut Creek, CA
  • NPI 1871550590
  Medicare reassignment Care Compare group NPD
• Doctors Hospital of Manteca, Inc.

  • General Acute Care Hospital
  • Manteca, CA
  • NPI 1992736599
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• San Ramon Regional Medical Center, LLC

  • General Acute Care Hospital
  • San Ramon, CA
  • NPI 1932131489
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982738712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N WIGET LN",
            "address_2": "STE 210",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982452",
            "telephone_number": "925-935-6252",
            "fax_number": "925-935-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LA CASA VIA",
            "address_2": "BLDG 2 SUITE 209",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983045",
            "telephone_number": "925-935-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "FANNIE",
        "middle_name": "WYNDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A85919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A85919",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sorrenta Chantel Stuart, MFT
• Genisa Stull, RN, BSN, CNOR
• Eniko Szidonia Sturts, RN
• Sarah Jo Styles, DO
• Ana T Su, RD
• Kevin L Suarez
• Virginia A Suarez, PSYD
• Shyni Subash, MD
• Cheyanne Santana Subias
• Ashly Marie Sublasky

• Allergy & Immunology Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Allergy & Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.