MR. WEIDONG SU PA-C
NPI 1306122973
Physician Assistant in Jacksonville, FL

Q: What is Weidong Su's NPI number?

The NPI number for Weidong Su is 1306122973. It was assigned to this individual provider in the NPPES registry on October 27, 2011.

Q: What is Weidong Su's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Weidong Su was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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 October 27, 2011PECOS EnrolledAccepts Medicare Assignment

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Weidong Su Pa-c NPPES

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

MR. WEIDONG SU PA-C (NPI 1306122973) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA9106187) and active in the NPI registry since October 2011. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1306122973

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. WEIDONG SUCredential: PA-C

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateOctober 27, 2011

Last NPPES UpdateFebruary 24, 2026

NPPES CertifiedFebruary 24, 2026

✔ NPI 1306122973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9106187

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Secondary Practice Location 1

Location 111565 N Main StJacksonville, FL 32218-4002 · Phone (904) 757-2811 · Fax (904) 757-0191

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Weidong Su Pa-c 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 ID6002046539

PECOS Enrollment IDI20140303001378

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.

Hospital Affiliations CMS Care Compare

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

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$215.65 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant