Jeannie Jiwon Su, MD - Medicare Urology in Santa Monica, CA

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Jeannie Jiwon Su, MD is a medicare enrolled "Urology" physician in Santa Monica, California. She went to University Of California, San Diego School Of Medicine and graduated in 2015 and has 9 years of diverse experience with area of expertise as Urology. She is a member of the group practice Providence Saint Johns Medical Foundation, Comprehensive Urology Medical Group, Comprehensive Urology Medical Group and her current practice location is 2121 Santa Monica Blvd, Santa Monica, California. You can reach out to her office (for appointments etc.) via phone at (310) 582-7137.

Jeannie Jiwon Su is licensed to practice in California (license number A168007) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922487800.

Contact Information

Jeannie Jiwon Su, MD
2121 Santa Monica Blvd,
Santa Monica, CA 90404-2303
(310) 582-7137
Not Available

Map and Direction




Physician's Profile

Full NameJeannie Jiwon Su
GenderFemale
SpecialityUrology
Experience9 Years
Location2121 Santa Monica Blvd, Santa Monica, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jeannie Jiwon Su attended and graduated from University Of California, San Diego School Of Medicine in 2015
  NPI Data:
  • NPI Number: 1922487800
  • Provider Enumeration Date: 05/25/2015
  • Last Update Date: 05/01/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4385956465
  • Enrollment ID: I20200611001972

Medical Identifiers

Medical identifiers for Jeannie Jiwon Su such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1922487800NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology A168007 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Cedars-sinai Medical CenterLos angeles, CAHospital
Providence Saint John's Health CenterSanta monica, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Saint Johns Medical Foundation0840548624315
Comprehensive Urology Medical Group82240671455
Comprehensive Urology Medical Group82240671455

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeannie Jiwon Su allows following entities to bill medicare on her behalf.
Entity NameComprehensive Urology Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760406250
PECOS PAC ID: 8224067145
Enrollment ID: O20050810000787
Entity NameJohn J Kowalczyk Do Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942436548
PECOS PAC ID: 1759493216
Enrollment ID: O20110607000827
Entity NameProvidence Saint Johns Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518438712
PECOS PAC ID: 0840548624
Enrollment ID: O20180810000904
Entity NameJsu Medical, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750068086
PECOS PAC ID: 4284095217
Enrollment ID: O20230807002048

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeannie Jiwon Su is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jeannie Jiwon Su, MD
1014 Broadway # 109,
Santa Monica, CA 90401-2808

Ph: (424) 432-2304		Jeannie Jiwon Su, MD
2121 Santa Monica Blvd,
Santa Monica, CA 90404-2303

Ph: (310) 582-7137

Reviews and Comments


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Gregory Scott Jack, M.D.
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Stacey C Carter, M.D.
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Practice Location: 1260 15th St, Suite 1200, Santa Monica, CA 90404
Phone: 310-451-8751    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.