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SHAN SU
NPI 1942836804
Radiology - Diagnostic Radiology in Boston, MA

Active since March 22, 2020PECOS Enrolled

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 5, 2025, Mar 22, 2020 (2 updates tracked since 2020).

About Shan Su NPPES

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

SHAN SU (NPI 1942836804) is an individual diagnostic radiology provider in Boston, Massachusetts, licensed in Massachusetts (1021679) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942836804
Entity TypeIndividualFemale
Primary Taxonomy2085R0202X
Provider Legal NameSHAN SU
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address55 Fruit StBoston, MA 02114-2621
Phone(617) 724-0288
Sole ProprietorNo
Enumeration DateMarch 22, 2020
Last NPPES UpdateJune 5, 20252 updates tracked since enumeration
NPPES CertifiedJune 5, 2025
✔ NPI 1942836804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in MA · 1021679
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
55 FRUIT ST, Boston, MA 02114
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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)

Shan 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 02114 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$78.84 typical visit price
range $21.07 – $155.29
Typical copayment $19.71 (range $5.26 – $38.82)
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.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Shan Su's NPI number?

The NPI number for Shan Su is 1942836804. It was assigned to this individual provider in the NPPES registry on March 22, 2020.

Where is Shan Su located?

Shan Su practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (617) 724-0288.

What is Shan Su's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Shan Su enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Shan Su was last updated on June 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.