MARISSA I-FANG SU MD
NPI 1245891712
Internal Medicine in Honolulu, HI

Q: What is Marissa Su's NPI number?

The NPI number for Marissa Su is 1245891712. It was assigned to this individual provider in the NPPES registry on June 25, 2019.

Q: What is Marissa Su's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Marissa Su was last updated on June 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 25, 2019PECOS EnrolledAccepts Medicare Assignment

1356 LUSITANA ST FL 7, HONOLULU, HI 96813(808) 586-2890 Get Directions Write a Review

NPPES record last updated: June 25, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Marissa I-fang Su Md NPPES

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

MARISSA I-FANG SU MD (NPI 1245891712) is an individual internal medicine provider in Honolulu, Hawaii, licensed in Hawaii (7792) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Crawford Memorial Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1245891712

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameMARISSA I-FANG SUCredential: MD

Location Address1356 LUSITANA ST FL 7Honolulu, HI 96813-2409

Mailing Address1356 Lusitana St Fl 7Honolulu, HI 96813-2409

Phone(808) 586-2890

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 25, 2019

✔ NPI 1245891712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in HI · 7792

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.

1356 LUSITANA ST FL 7, Honolulu, HI 96813

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Marissa I-fang Su Md 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 ID3173904893

PECOS Enrollment IDI20250721000605

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 Marissa Su reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Good Samaritan Hospital Physician Services, Inc

4,279 mi

Nurse Practitioner

429 S 6TH ST
Vincennes, IN 47591

Reassigned Medicare billing, Indiana enrollment
171 clinicians in this Medicare group

NPI 1336576875 (812) 885-8690

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

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Crawford Memorial Hospital

Critical Access Hospitals · Robinson, IL

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141343

Location1000 North Allen StreetRobinson, IL 62454 · Crawford County

Emergency services

Good Samaritan Hospital

Acute Care Hospitals · Vincennes, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number150042

Location520 S 7th StVincennes, IN 47591 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96813 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

$136.68 typical visit price

range $60.53 – $180.05

Typical copayment $34.17 (range $15.13 – $45.01)

Most-billed visit code 99204

Established Patient

$105.65 typical visit price

range $20.09 – $147.56

Typical copayment $26.41 (range $5.02 – $36.89)

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.

TARYN KIKUE MIYAKE MD

Internal Medicine