Individual provider Active NPI

Eyong John Ly, MD

  • Hospitalist Physician
  • Santa Monica, CA
National Provider Identifier
1053575886
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A113044 Issued in CA
Practice address
1250 16TH St
Suite A454
Santa Monica, CA 90404-1249
Phone
(310) 319-4698
Fax
(310) 319-4908
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A113044 CA Primary

Addresses

Primary practice location

1250 16TH St
Suite A454
Santa Monica, CA 90404-1249

Mailing address

1250 16TH St
Suite A454
Santa Monica, CA 90404-1249
Phone (310) 319-4698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20120510000298 CA Practitioner - Internal Medicine 1557523404 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Warren Alpert Medical School of Brown University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1245 16TH St
Santa Monica, CA 90404-1239

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 267-9643

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A113044CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents University of California CurrentSince Dec 17, 2023 Accepting new patients
Regents University of California CurrentSince Dec 17, 2023 Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1250 16th St
Ste A454
Santa Monica, CA 90404
Phone (310) 301-9469

1260 15th St
Ste 1501
Santa Monica, CA 90404
Phone (310) 656-1700

1245 16th St
Ste 125
Santa Monica, CA 90404
Phone (310) 315-8900

Interoperability endpoints

  • Direct secure messaging: ely25305@direct.uclahealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1053575886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 16TH ST",
            "address_2": "SUITE A454",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 16TH ST",
            "address_2": "SUITE A454",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041249",
            "telephone_number": "310-319-4698",
            "fax_number": "310-319-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "EYONG",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A113044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.