Individual provider Active NPI

Daniel Chan Ly, DO

  • Pediatrics Physician
  • Fogelsville, PA
National Provider Identifier
1194217224
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS021279 Issued in PA
Practice address
1431 Nursery St Ste 102
Fogelsville, PA 18051-1612
Phone
(610) 821-4920
Fax
(610) 821-1358
NPI assigned
Jun 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OT018602 PA
Pediatrics Physician 208000000X OS021279 PA Primary

Addresses

Primary practice location

1431 Nursery St Ste 102
Fogelsville, PA 18051-1612

Mailing address

2100 Mack Blvd
Allentown, PA 18103-5622
Phone (484) 884-0617

Other practice location 1

1200 S Cedar Crest Blvd Fl 6
Allentown, PA 18103-6202
Phone (610) 402-7712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210714001877 PA Practitioner - Pediatric Medicine 3870848237 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2021 Accepting new patients
Lehigh Valley Physician Group Pediatrics Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jul 1, 2021 Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Hospital Past Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1200 S Cedar Crest Blvd
Fl 6
Allentown, PA 18103
Phone (610) 402-7712

1611 Pond Rd
Ste 400
Allentown, PA 18104
Phone (610) 395-4300

1431 Nursery St
Ste 102
Fogelsville, PA 18051
Phone (610) 395-4444

1431 Nursery St
Ste 210
Fogelsville, PA 18051

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: dly298459@direct2.lvhn.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1194217224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-0617",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 NURSERY ST STE 102",
            "city": "FOGELSVILLE",
            "state": "PA",
            "postal_code": "180511612",
            "telephone_number": "610-821-4920",
            "fax_number": "610-821-1358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Cedar Crest Blvd Fl 6",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036202",
            "country_code": "US",
            "telephone_number": "610-402-7712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "DANIEL",
        "middle_name": "CHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OT018602",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS021279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fogelsville, PA

Sources for this page

Verify at the official NPI Registry.