XUANTONG SU
NPI 1790500205
Nurse Practitioner - Family in Chino, CA
About Xuantong Su NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
XUANTONG SU (NPI 1790500205) is an individual family provider in Chino, California, licensed in California (95033018) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Xuantong Su is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Xuantong Su reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Chino, CA 91710
- Reassigned Medicare billing, California enrollment
- 11 clinicians in this Medicare group
Mariposa, CA 95338
- Reassigned Medicare billing, California enrollment
- 179 clinicians in this Medicare group
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 91710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Xuantong Su's NPI number?
The NPI number for Xuantong Su is 1790500205. It was assigned to this individual provider in the NPPES registry on November 19, 2024.
Where is Xuantong Su located?
Xuantong Su practices at 13768 Roswell Ave Ste 118, Chino, CA 91710. The listed phone number is (951) 866-4339.
What is Xuantong Su's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Xuantong Su enrolled in Medicare?
Yes. Xuantong Su is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Xuantong Su's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Xuantong Su reassigns Medicare benefits to 2 organizations: Totalcare Walk In Clinic Inc (Chino, CA) and Community Health Centers Of America (Mariposa, CA). Each 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 Xuantong 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 Xuantong Su was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Xuantong Su · NPI 1790500205
Family physician in Chino, California. Individual provider, active in the CMS NPPES registry since November 19, 2024.
## Identity
- **NPI:** 1790500205 (Entity type: Individual)
- **Enumerated:** November 19, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95033018 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 13768 ROSWELL AVE STE 118, Chino, CA 91710-1402
- **Phone:** (951) 866-4339
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Totalcare Walk In Clinic Inc (NPI 1760689715, Chino, CA); Community Health Centers Of America (NPI 1891207684, Mariposa, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 19, 2024
---
Source: [NPI Profile](https://npiprofile.com/npi/1790500205) · Data from the CMS NPPES public registry.