KENNETH C.H. SU MD
NPI 1891862629
Obstetrics & Gynecology in Riverside, CA

Q: What is Kenneth Su's NPI number?

The NPI number for Kenneth Su is 1891862629. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Q: What is Kenneth Su's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Su was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 November 29, 2006PECOS EnrolledAccepts Medicare Assignment

10800 MAGNOLIA AVE, RIVERSIDE, CA 92505(909) 353-2000 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kenneth C.h. Su Md NPPES

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

KENNETH C.H. SU MD (NPI 1891862629) is an individual obstetrics & gynecology provider in Riverside, California, licensed in California (G87763) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (1993).

NPPES Registry Identity

NPI1891862629

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameKENNETH C.H. SUCredential: MD

Location Address10800 MAGNOLIA AVERiverside, CA 92505-3043

Mailing Address10800 Magnolia AveRiverside, CA 92505-3043 · (909) 353-2000

Phone(909) 353-2000

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 1993

Enumeration DateNovember 29, 2006

Last NPPES UpdateNovember 29, 2021

✔ NPI 1891862629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in CA · G87763

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

10800 MAGNOLIA AVE, Riverside, CA 92505

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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

Kenneth C.h. 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 ID1557358660

PECOS Enrollment IDI20081118000019

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

Southern California Permanente Medical Group

Same address

Health Maintenance Organization

10800 MAGNOLIA AVE
Riverside, CA 92505

Reassigned Medicare billing, California enrollment
Also billed through NPI 1952333460 (California)
5,228 clinicians in this Medicare group

NPI 1316979834 (866) 984-7483

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 92505 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

$136.04 typical visit price

range $59.60 – $179.42

Typical copayment $34.01 (range $14.90 – $44.85)

Most-billed visit code 99204

Established Patient

$74.08 typical visit price

range $19.37 – $146.42

Typical copayment $18.52 (range $4.84 – $36.60)

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.

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.

KAISER PERMANENTE

General Acute Care Hospital