Long Ly, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

99267 Issued in GA

Practice address

1819 Peachtree Street
Suite 600
Atlanta, GA 30309-1848

Phone

(404) 350-5777

Fax

(404) 350-5755

NPI assigned

Apr 22, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lly@metroderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Metroderm, P.C.

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
  • NPI 1205833894

  GA

  Medicare reassignment Care Compare group NPD
• Metroderm, P.C.

  • Specialist
  • Gainesville, GA
  • NPI 1942929062
  NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1023638871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 JOHNSON FY RD NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421418",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 PEACHTREE STREET",
            "address_2": "SUITE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091848",
            "telephone_number": "404-350-5777",
            "fax_number": "404-350-5755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Johnson Fy Rd NE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421418",
            "country_code": "US",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "LONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "99267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LV Wellness LLC
• LVD Surgical Associates
• Ashley Lwin, FNP-C
• Bao Chau Khuong Ly
• Justin Hy-Khang Ly
• Sara Lynn Ly, PHARMD
• Shin Lee Ly, PHARM.D.
• Abby Lyall
• Nathan Scott Lycan, PA
• Kenneth Eugene Lyda, FNP

• All providers in Atlanta, GA
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.