Active NPI
Samantha Vivian Ly, RN, BSN
- Registered Nurse
- Boston, MA
National Provider Identifier
1033752050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN2337120
- Practice address
- 780 Albany St
Boston, MA 02118-2755 - Phone
- (857) 654-1000
- Fax
- (857) 654-1100
- NPI assigned
- Oct 22, 2019
- Last updated
- Oct 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2337120 | MA | Primary |
Addresses
Primary practice location
780 Albany St
Boston, MA 02118-2755
Mailing address
780 Albany St
Boston, MA 02118-2755
Phone (857) 654-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2337120 | MA | MD | Registered Nurse |
Interoperability endpoints
- samantha.ly@398008301912068.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1033752050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182755",
"telephone_number": "857-654-1000",
"fax_number": "857-654-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 ALBANY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182755",
"telephone_number": "857-654-1000",
"fax_number": "857-654-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "SAMANTHA",
"middle_name": "VIVIAN",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2337120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.