DR. KEVIN WAYNE SU (NPI# 1538521356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538521356 |
| Entity Type | Individual |
| Full Name | DR. KEVIN WAYNE SU |
| Credential | M.D. |
| Practice Address |
725 Albany St Shapiro 5 & 6 Boston MA 02118-2526 |
| Practice Telephone | 6174145951 |
| Practice Fax Number | 6174149251 |
| Mailing Telephone | 6174145951 |
| Mailing Fax Number | 6174149251 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-04-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 277976 | MA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 277976 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MA STATE MEDICAL LICENSE | 277976 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791524 | Kevin Su | Dentist | 366 W Lake Mead Pkwy Ste 100, Henderson, NV 89015-7287 | 2019-07-09 |
| 1962908129 | Kevin N Su | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, Bb-1469, Seattle, WA 98195-6540 | 2018-04-04 |
| 1497043467 | Kevin Su | Pharmacist | 3020 Ne 45th St, Seattle, WA 98105-5002 | 2011-07-12 |
| Street Address |
725 ALBANY ST SHAPIRO 5 & 6 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750389565 | Amitabh Gautam | Transplant Surgery | 725 Albany St, Shapiro 7th Floor, Suite 7a, Boston, MA 02118-2526 | 2005-07-14 |
| 1679186381 | Rachel Brigell Kearney | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-08-24 |
| 1588292767 | Karishma Pareek | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-04-01 |
| 1912535238 | Rebecca Zoe Steuer | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-31 |
| 1316574676 | Jasmine Vakhshoorzadeh | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-26 |
| 1700413176 | Ava Bakhtyari | Student in an Organized Health Care Education/Training Program | 725 Albany St, Precepting Room, Boston, MA 02118-3549 | 2020-03-25 |
| 1477180800 | Jacqueline Dinh | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-25 |
| 1114554821 | Nina Victoria Abon | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-24 |
| 1225665839 | Konstantinos Christos Hantzidiamantis | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-24 |
| 1790312668 | Leonie Hoyo | Student in an Organized Health Care Education/Training Program | 725 Albany St, Boston, MA 02118-3549 | 2020-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265042832 | Rinat Nuriev | Internal Medicine | 530 Western Ave Apt 404, Boston, MA 02135-1036 | 2020-08-07 |
| 1831726595 | James Dotimas | Internal Medicine | 801 Massachusetts Ave Ste 6c, Boston, MA 02118-2605 | 2020-03-24 |
| 1487291100 | Evolvd Health | Internal Medicine | 85 Brainerd Rd Apt 108, Boston, MA 02134-4529 | 2019-12-01 |
| 1821658709 | Jennifer Drummond | Internal Medicine | 800 Washington St. Gme Office, Boston, MA 02111 | 2019-06-13 |
| 1699237081 | Steven Lynn St Peter | Internal Medicine | 43 Union Park Apt 2, Boston, MA 02118-3702 | 2019-04-03 |
| 1083174478 | Kevin Stirling | Internal Medicine | Shapiro Primary Care 725 Albany Street, 5b/c Precepting Room, Boston, MA 02118 | 2019-03-21 |
| 1477042737 | Theofanis Kalathas | Internal Medicine | 725 Albany Street, Shapiro 5d6, Boston, MA 02118 | 2018-05-02 |
| 1801309521 | Firefly Health | Internal Medicine | 361 Newbury St Fl 5, Boston, MA 02115-2738 | 2017-11-16 |
| 1104346527 | Jodian Amor Pinkney | Internal Medicine | 55 Fruit St # 130, Boston, MA 02114-2621 | 2017-06-27 |
| 1568982502 | Priyanka Ballal | Internal Medicine | 725 Albany Street, Shapiro 586, Boston, MA 02118-2526 | 2017-06-21 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.