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SU SU HLINE M.D.
NPI 1174652259
Internal Medicine in Loma Linda, CA

Active since March 05, 2007PECOS EnrolledAccepts Medicare Assignment
11370 ANDERSON ST, 3150, LOMA LINDA, CA 92354(909) 558-2191 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Su Su Hline M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SU SU HLINE M.D. (NPI 1174652259) is an individual internal medicine provider in Loma Linda, California, licensed in California (A88832) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1987).

NPPES Registry Identity

NPI1174652259
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSU SU HLINECredential: M.D.
Location Address11370 ANDERSON ST, 3150Loma Linda, CA 92354-3450
Mailing AddressFile # 56994Los Angeles, CA 90074-4701 · (909) 558-3111
Phone(909) 558-2191
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateMarch 5, 2007
Last NPPES UpdateDecember 3, 2021
✔ NPI 1174652259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A88832
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X · License A88832 (CA)
11370 ANDERSON ST, Loma Linda, CA 92354
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Su Su Hline M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153337324
PECOS Enrollment IDI20060224000352
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Su Hline reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
10.0 mi
Health Maintenance Organization
9961 SIERRA AVE
Fontana, CA 92335
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1952333460 (California)
  • 5,228 clinicians in this Medicare group
NPI 1689606196 (909) 427-3910

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA VILLAFRANCO
Social Worker (Clinical)
11370 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-5978
JOHN Y KIM M.D.
Otolaryngology
11370 ANDERSON ST, SUITE 2100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2822
EDMUND YUEY KUN KO M.D.
Urology
11370 ANDERSON ST, SUITE 1100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2830
SNORRI OLAFSSON M.D.
Internal Medicine (Gastroenterology)
11370 ANDERSON ST, STE 3150
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2191
SIGVE K. TONSTAD M.D.
Internal Medicine
11370 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2870
KHASHAYAR DASHTIPOUR M.D.
Psychiatry & Neurology (Neurology)
11370 ANDERSON ST, SUITE 2400
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2880
DOUGLAS DEMING M.D.
Pediatrics (Neonatal-Perinatal Medicine)
11370 ANDERSON ST, STE B-100
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2848
ABEL TORRES M.D.
Dermatology (MOHS-Micrographic Surgery)
11370 ANDERSON ST, STE 2600
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Su Hline's NPI number?

The NPI number for Su Hline is 1174652259. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Where is Su Hline located?

Su Hline practices at 11370 Anderson St 3150, Loma Linda, CA 92354. The listed phone number is (909) 558-2191.

What is Su Hline's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Su Hline enrolled in Medicare?

Yes. Su Hline is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Su Hline's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Su Hline reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Su Hline's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Su Hline was last updated on December 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.