Justin Alexander Ly, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MT225615 Issued in PA

Practice address

3401 N Broad St
Department of Orthopadic Surgery & Sports Medicine
Philadelphia, PA 19140

Phone

(484) 343-3159

NPI assigned

Jun 7, 2022

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

Electronic endpoints 1

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1124757000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 N BROAD ST",
            "address_2": "BOYER PAVILLION SUITE 226 SUITE 226P",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "DEPARTMENT OF ORTHOPADIC SURGERY & SPORTS MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "484-343-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "JUSTIN",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MT225615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.ly@tuhs.temple.edu",
            "affiliation": "N",
            "endpointDescription": "Temple University Hospital E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3401 N Broad St",
            "address_2": "Department of Orthopaedic Surgery & Sports Medicine",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anh Ngoc Ly, DMD
• Brandon Henry Ly
• Carol Ly, PHARMD
• Chen T Ly, OD
• Jacqueline Huang Ly, APRN
• Lucky Ly, DO
• Mui Tai Ly, O.D.
• Peter Ly
• Peter Phan Ly
• Quynh Nhu Ly

• Orthopaedic Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Orthopaedic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.