Colleen Ann Ly, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA63447 Issued in CA

Practice address

4060 Fourth Ave Ste 700
San Diego, CA 92103-2121

Phone

(619) 299-8500

NPI assigned

Oct 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

On Call Specialists Medical Group of San Diego IncGroup PAC ID 7911395231, 145 clinicians

California Orthopaedic Institute Medical Associates IncGroup PAC ID 1456246388, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077
• Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles (1 of 2)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• California Orthopaedic Institute Medical Associates, Inc

  • Orthopaedic Surgery Physician
  • San Diego, CA
  • NPI 1245290899

  CA

  Medicare reassignment Care Compare group
• On Call Specialists Medical Group of San Diego, Inc.

  • Specialist
  • San Diego, CA
  • NPI 1962175836

  CA

  Medicare reassignment Care Compare group
• San Diego Orthopaedic Associates Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1407817448

  CA

  Medicare reassignment
• California Orthopaedic Institute Medical Associates, Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1659317204
  NPD

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

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446

  Hospital

  Care Compare affiliation
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841233780

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1184404261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-299-8500",
            "fax_number": "619-299-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 FOURTH AVE STE 700",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032121",
            "telephone_number": "619-299-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "COLLEEN",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63447",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA63447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ly
• Anhdao Tran Ly, R.PH.
• Anne Ly, PHARM.D
• Binh T Ly, MD
• Chong Ly
• Deanna Ly
• Jennifer T Ly, PHARM D
• Kevin Ly
• Lien Ly
• Linda Ly

• All providers in San Diego, CA
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.