Phuong Ly, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95006259 Issued in CA

Practice address

19121 Beach Blvd
Huntington Beach, CA 92648-2307

Phone

(714) 848-1522

NPI assigned

Mar 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Minuteclinic Diagnostic Medical Group of Orange County Inc

  • Nurse Practitioner
  • Irvine, CA
  • NPI 1104013879

  Family

  Medicare reassignment NPD

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1174063366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19121 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19121 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482307",
            "telephone_number": "714-848-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "PHUONG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxury Living Senior Care
• Chau Dang Ly
• Michelle W Ly, D.O.
• Serena Ly, DDS
• Michael Lyday
• Douajong Lyfoung
• Jeneen Lyle
• Carolyn Nagel Lyn, PA-C

• Family Nurse Practitioner in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.