JEANNIE JIWON SU (M.D.) – Urology Physician, NPI 1922487800

JEANNIE JIWON SU (M.D.) is a healthcare provider. based in Santa monica, California. specializing in UROLOGY. They hold the professional credentials M.D.. They hold a License No. A168007 (CA). The NPI Number for JEANNIE JIWON SU (M.D.) is 1922487800

Main info

Female
Sole Proprietor
11 Years Of Experience
Name
JEANNIE JIWON SU (M.D.)
NPI
1922487800
Phone
(310) 582-7137
Address
2200 SANTA MONICA BLVD STE 131
Enumeration Date
25 May 2015
Last Update Date
28 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6612538000
Graduation Year
2015 (11 years ago)
PAC ID
4385956465
Group Practice PAC ID
5193789121
Professional Enrollment ID
I20200611001972
Address ID
CA913552001VA23845PKWY300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Digital endpointsOther names

1,307 UROLOGY in CA

Provider Addresses for JEANNIE JIWON SU (M.D.)

  • 2200 SANTA MONICA BLVD STE 131

    SANTA MONICA, CA 904042312

    Phone: (310) 582-7137

    Fax: (310) 582-7140

    Type: Mailing

  • 2121 SANTA MONICA BLVD

    SANTA MONICA, CA 904042303

    Phone: (310) 582-7137

    Type: Location

  • 8631 W 3rd St Ste 1115E

    Los Angeles, CA 900485901

    Phone: (310) 278-8330

    Fax: (310) 278-7595

    Type: Location

  • 8631 W 3RD ST STE 1115E

    LOS ANGELES, CA 900485901

    Phone: (310) 278-8330

    Fax: (310) 278-7595

    Type: Mailing

  • 1014 BROADWAY # 109

    SANTA MONICA, CA 904012808

    Phone: (424) 432-2304

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 108 Open Payments records for all available years, with a total value of $4,884.

Total Amount is formed as General ($4,884) + Research ($0) + Ownership ($0) = $4,884.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: COLOPLAST CORP ($803).

Total Amount

$4,884

General + Research + Ownership

Payments

108

Total payment records

General Amount

$4,884

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200611001972IUrologyCATBD
I20230124000565IUrologyTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
87798Detection test by nucleic acid for organism, amplified probe technique1,74786$0
87481Detection test for candida species (yeast), amplified probe technique66786$0
81001Manual urinalysis test with examination using microscope, automated497207$0
99214Established patient office or other outpatient visit, 30-39 minutes353160$0
87801Detection test by nucleic acid for multiple organisms, amplified probe(s) technique34176$0
View full utilization report →

Insurance plans in this area (ZIP 90404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193789121View full group profile
NameSpecialtyState
General SurgeryCA
General SurgeryCA
General Surgery, Surgical OncologyCA
U R O L O G YCA
U R O L O G YNY
General SurgeryCA
General SurgeryCA
U R O L O G YCA

Reviews

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Frequently asked questions

Can I cross-check JEANNIE JIWON SU (M.D.) using NPI 1922487800?
NPI 1922487800 belongs to JEANNIE JIWON SU (M.D.); compare other details if you need extra assurance.
Is JEANNIE JIWON SU (M.D.) shown as active in public data?
Registry records indicate JEANNIE JIWON SU (M.D.) maintains an active NPI.
What clinical focus is listed for JEANNIE JIWON SU (M.D.)?
At a glance, JEANNIE JIWON SU (M.D.) is tied to Urology Physician. Clinical services aligned with this taxonomy classification.
Is JEANNIE JIWON SU (M.D.) located near Santa Monica?
JEANNIE JIWON SU (M.D.) currently maps to Santa Monica, California in this extract.
Can I trust this NPI listing for JEANNIE JIWON SU (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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