Duong Thai Ly, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

24121 Issued in WV

Practice address

1006 Tavern Rd
Martinsburg, WV 25401-2864

Phone

(304) 267-5141

Fax

(304) 267-5140

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, WV, DC3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Tri-State Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Martinsburg, WV
  • NPI 1316025760
  Medicare reassignment NPD
• First Colonies Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Columbia, MD
  • NPI 1740218767

  DC

  Medicare reassignment NPD
• Tri-State Surgical Center, LLC

  • Anesthesiology Physician
  • Martinsburg, WV
  • NPI 1053939074
  NPD
• Blue Ridge Anesthesia Associates LLC

  • Anesthesiology Physician
  • Hagerstown, MD
  • NPI 1407964646
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1124032917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62556",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642556",
            "telephone_number": "302-709-4528",
            "fax_number": "302-733-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012864",
            "telephone_number": "304-267-5141",
            "fax_number": "304-267-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "DUONG",
        "middle_name": "THAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D69151",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "24121",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101246849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Marie Lupinetti, LPC
• Doris Luthi
• Brittany Lutz-Hoffman
• David Lutz
• LW Care LLC
• Robert J Lynch, MD
• Chara Lyndon
• Donna Lyons
• Stephanie R Mabie, PA-C
• Brandi Renee Macdonald

• Anesthesiology Physician in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Anesthesiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.

Verify at the official NPI Registry.