JEANNIE JIWON SU M.D.
NPI 1922487800
Urology in Santa Monica, CA

Active since May 25, 2015PECOS Enrolled
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404(310) 582-7137 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 27, 2025, May 1, 2024, Jul 7, 2023 and 2 more (5 updates tracked since 2020).

About Jeannie Jiwon Su M.d. NPPES

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

JEANNIE JIWON SU M.D. (NPI 1922487800) is an individual urology provider in Santa Monica, California, licensed in California (A168007) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1922487800
Entity TypeIndividualFemale
Primary Taxonomy208800000X
Provider Legal NameJEANNIE JIWON SUCredential: M.D.
Location Address2121 SANTA MONICA BLVDSanta Monica, CA 90404-2303
Mailing Address1014 Broadway # 109Santa Monica, CA 90401-2808 · (424) 432-2304
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateMay 25, 2015
Last NPPES UpdateOctober 28, 20255 updates tracked since enumeration
NPPES CertifiedOctober 28, 2025
NPI 1922487800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License Licensed in CA · A168007
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2121 SANTA MONICA BLVD, Santa Monica, CA 90404

Secondary Practice Location 1

Location 18631 W 3rd St Ste 1115ELos Angeles, CA 90048-5901 · Phone (310) 278-8330 · Fax (310) 278-7595

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jeannie Jiwon Su M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4385956465
PECOS Enrollment IDI20200611001972, I20230124000565
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.

Areas of Expertise CMS Part B claims 74

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Detection test by nucleic acid for organism, amplified probe technique 87798
A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.
1,326 services63 patients
Detection test for candida species (yeast), amplified probe technique 87481
This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.
510 services63 patients
Manual urinalysis test with examination using microscope, automated 81001
A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.
372 services155 patients
Detection test by nucleic acid for multiple organisms, amplified probe(s) technique 87801
This is a test that identifies various microorganisms in your body using a method called amplified probe technique. It targets specific genetic material (nucleic acids) of the organisms, amplifying them for easy detection. This helps in diagnosing infections accurately.
297 services62 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
297 services141 patients
Insertion of lower leg neurostimulator electrode 64566
The insertion of a lower leg neurostimulator electrode is a procedure where a small device is placed under your skin. This device sends mild electrical signals to nerves in the lower leg, helping to manage chronic pain. It's a safe, minimally invasive procedure.
175 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90404 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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.

Hospitalist
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Dermatology
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Anesthesiology
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Internal Medicine (Critical Care Medicine)
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Student in an Organized Health Care Education/Training Program
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Physician Assistant
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Hospitalist
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404
Emergency Medicine
2121 SANTA MONICA BLVD
SANTA MONICA, CA 90404

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 Jeannie Su's NPI number?

The NPI number for Jeannie Su is 1922487800. It was assigned to this individual provider in the NPPES registry on May 25, 2015.

Where is Jeannie Su located?

Jeannie Su practices at 2121 Santa Monica Blvd, Santa Monica, CA 90404. The listed phone number is (310) 582-7137.

What is Jeannie Su's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Jeannie Su enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jeannie Su was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.