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KEVIN SU MD
NPI 1740983436
Psychiatry & Neurology - Child & Adolescent Psychiatry in New York, NY

Active since March 23, 2023PECOS Enrolled
1901 1ST AVE, NEW YORK, NY 10029(212) 423-6262 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 22, 2026, Mar 23, 2023 (2 updates tracked since 2023).

About Kevin Su Md NPPES

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

KEVIN SU MD (NPI 1740983436) is an individual child & adolescent psychiatry provider in New York, New York, licensed in New York (338733) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Elmhurst, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1740983436
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameKEVIN SUCredential: MD
Location Address1901 1ST AVENew York, NY 10029-7491
Mailing Address3961 48th St # 1rSunnyside, NY 11104-1021
Phone(212) 423-6262
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 23, 2023
Last NPPES UpdateJuly 22, 20262 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1740983436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NY · 338733
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
1901 1ST AVE, New York, NY 10029
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Secondary Practice Location 1

Location 17901 BroadwayElmhurst, NY 11373-1329 · Phone (718) 334-1502

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Su Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214497858
PECOS Enrollment IDI20260903000093
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 Kevin Su reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York City Health And Hospitals Corporation
1.0 mi
Skilled Nursing Facility
900 MAIN ST, ROOM A22-4
New York, NY 10044
  • Reassigned Medicare billing, New York enrollment
  • 1,615 clinicians in this Medicare group
NPI 1679581607 (212) 848-6263

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

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.

KENNETH BOMPAROLA PA
Physician Assistant
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
ESEOGHENE INYANG AKAMUNE PHARMD
Pharmacist (Pharmacotherapy)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6262
JONATHAN CHABON MD
Emergency Medicine
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6684
KRITI BHANDARI MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 988-5168
SEBASTIAN MARK MENDEZ
Psychiatry & Neurology (Psychiatry)
1901 1ST AVE
NEW YORK, NY 10029
New York County (646) 672-3143
KYRA QUYNN MANAYAN-LEONARD MD
Student in an Organized Health Care Education/Training Program
1901 1ST AVE
NEW YORK, NY 10029
New York County (844) 692-4692
ELENA ALAYETO LCSW
Social Worker (Clinical)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-8633
BEATA EDYTA POPIS-MATEJAK MD
Internal Medicine (Critical Care Medicine)
1901 1ST AVE
NEW YORK, NY 10029
New York County (212) 423-6771

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 Kevin Su's NPI number?

The NPI number for Kevin Su is 1740983436. It was assigned to this individual provider in the NPPES registry on March 23, 2023.

Where is Kevin Su located?

Kevin Su practices at 1901 1st Ave, New York, NY 10029. The listed phone number is (212) 423-6262.

What is Kevin Su's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Kevin Su enrolled in Medicare?

Yes. Kevin Su is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kevin Su's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Su reassigns Medicare benefits to New York City Health And Hospitals Corporation (New York, NY). 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 Kevin Su'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 Kevin Su was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.