Individual provider Active NPI

Lily Nguyen, PA-S

  • Physician Assistant
  • Ludlow, MA
National Provider Identifier
1043994965
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA102356 Issued in MA
Practice address
471 Center St
Ludlow, MA 01056-2733
Phone
(413) 625-3500
Fax
(413) 625-3655
NPI assigned
Jun 12, 2023
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA102356 MA Primary

Addresses

Primary practice location

471 Center St
Ludlow, MA 01056-2733

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other practice location 1

588 Longmeadow St
Longmeadow, MA 01106-2212
Phone (413) 286-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260127000630 MA Practitioner - Physician Assistant 9830676337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

471 Ctr St
Ludlow, MA 01056-2733
Phone (413) 625-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA102356MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Health Center, Inc CurrentSince Jan 19, 2026 Accepting new patients
Caring Health Center, Inc. CurrentSince Jan 19, 2026 Accepting new patients
Baystate Medical Practices, Inc PastSince Jun 18, 2023 Accepting new patients
Mercy Inpatient Medical Associates Inc. Past Accepting new patients

Locations

473 Sumner Ave
#477
Springfield, MA 01108

1235 Boston Rd
Springfield, MA 01119
Phone (413) 693-1061

860 Boston Rd
Springfield, MA 01119
Phone (413) 783-9616

1049 Main St
Springfield, MA 01103
Phone (413) 304-4606

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1043994965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 CENTER ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010562733",
            "telephone_number": "413-625-3500",
            "fax_number": "413-625-3655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "588 Longmeadow St",
            "address_purpose": "LOCATION",
            "city": "Longmeadow",
            "state": "MA",
            "postal_code": "011062212",
            "country_code": "US",
            "telephone_number": "413-286-6515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LILY",
        "credential": "PA-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA102356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludlow, MA

Sources for this page

Verify at the official NPI Registry.