JASON T SU (DO) – Pediatric Cardiology Physician, NPI 1427137991
Pediatric Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
134 PEDIATRIC MEDICINE in ME
Provider Addresses for JASON T SU (DO)
71 US Route 1 Ste C
Scarborough, ME 040747174
Phone: (207) 883-5532
Type: Location
1055 N 300 W STE 311
PROVO, UT 846043373
Phone: (385) 477-6800
Fax: (385) 477-6801
Type: Location
311, North 300 West, Timp, Provo, Utah County, Utah, 84601, United States
PROVO, UT 846043373
Phone: (385) 477-6800
Fax: (385) 477-6801
Type: Mailing
Primary Children's Hospital, 100, Mario Capecchi Drive, Salt Lake City, Salt Lake County, Utah, 84113, United States
SALT LAKE CITY, UT 841131103
Phone: (801) 662-5400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 20 Open Payments records for all available years, with a total value of $405.
Total Amount is formed as General ($405) + Research ($0) + Ownership ($0) = $405.
Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Baxter Healthcare ($49).
Total Amount
$405
General + Research + Ownership
Payments
20
Total payment records
General Amount
$405
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Baxter Healthcare | $49 |
| ANI Pharmaceuticals, Inc. | $41 |
| CMP Pharma, Inc. | $38 |
| Janssen Biotech, Inc. | $37 |
| SHORLA ONCOLOGY INC. | $34 |
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: 2024-10-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040802000676 | I | Pediatric Medicine | UT | TBD |
| I20201116001557 | I | Pediatric Medicine | WY | TBD |
| I20241029000329 | I | Pediatric Medicine | ME | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04074)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | PA | |
| - | ME | |
| - | ME | |
| - | ME | |
| - | ME | |
| Family Practice, Hospice/Palliative Care | ME | |
| Pediatric Medicine, Endocrinology | MA | |
| - | ME | |
| Family Practice | ME | |
| Nurse Practitioner | ME |
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