Jason T Su, DO in Provo, UT - Medicare Pediatrics

Jason T Su, DO is a medicare enrolled "Pediatrics - Pediatric Cardiology" physician in Provo, Utah. His current practice location is 1055 N 300 W Ste 311, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (385) 477-6800.

Jason T Su is licensed to practice in Utah (license number 5665627-1204) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427137991.

Contact Information

	Jason T Su, DO
	1055 N 300 W Ste 311, Provo, UT 84604-3373
	(385) 477-6800
	(385) 477-6801

Map and Direction

Physician's Profile

Full Name	Jason T Su
Gender	Male
Speciality	Pediatrics - Pediatric Cardiology
Location	1055 N 300 W Ste 311, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427137991
Provider Enumeration Date: 11/03/2006
Last Update Date: 10/18/2024

Medicare PECOS Information:

PECOS PAC ID: 0143291427
Enrollment ID: I20040802000676

Medical Identifiers

Medical identifiers for Jason T Su such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427137991	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0202X	Pediatrics - Pediatric Cardiology	DO3974 (Maine)	Secondary
2080P0202X	Pediatrics - Pediatric Cardiology	5665627-1204 (Utah)	Primary

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. Jason T Su allows following entities to bill medicare on his behalf.

Entity Name	Peak Ent Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346489036 PECOS PAC ID: 4284781543 Enrollment ID: O20090402000646

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. Jason T 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 Address	Practice Location Address
Jason T Su, DO 1055 N 300 W Ste 311, Provo, UT 84604-3373 Ph: (385) 477-6800	Jason T Su, DO 1055 N 300 W Ste 311, Provo, UT 84604-3373 Ph: (385) 477-6800

Reviews and Comments

Pediatrics Doctors in Provo, UT

Dr. Joshua Darrell Fuller, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1675 N Freedom Blvd Ste 3, Provo, UT 84604 Phone: 801-377-8000
Jordan Gaudio, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-1700
Danielle Elise Smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-8411
Dr. Chuanchau Jerry Jou, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 311, Provo, UT 84604 Phone: 385-477-6800 Fax: 385-477-6801
Leslie Mark Lang, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7707
Bradley Wayne Anderson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1355 N University Ave, #210, Provo, UT 84604 Phone: 801-373-8930 Fax: 801-377-6811
Dr. Matthew Joseph Clayton, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604 Phone: 801-377-4800 Fax: 801-377-4041

Jason T Su, DO - Medicare Pediatrics in Provo, UT