XUANTONG SU
NPI 1790500205
Nurse Practitioner - Family in Chino, CA

Q: 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.

Q: What is Xuantong Su's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: 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 20 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 November 19, 2024PECOS Enrolled

13768 ROSWELL AVE STE 118, CHINO, CA 91710(951) 866-4339 Get Directions Write a Review

NPPES record last updated: November 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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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

NPI1790500205

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameXUANTONG SU

Location Address13768 ROSWELL AVE STE 118Chino, CA 91710-1402

Mailing Address13768 Roswell Ave Ste 118Chino, CA 91710-1402 · (951) 866-4339

Phone(951) 866-4339

Sole ProprietorNo

Enumeration DateNovember 19, 2024

NPPES CertifiedNovember 19, 2024

✔ NPI 1790500205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95033018

13768 ROSWELL AVE STE 118, Chino, CA 91710

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

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.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

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.

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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.

DI FENG FNP

Nurse Practitioner (Family)