Individual provider Active NPI

Lily Ahn

  • Physical Therapist
  • Irvine, CA
National Provider Identifier
1225718463
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304252 Issued in CA
Practice address
17332 Von Karman Ave Ste 120
Irvine, CA 92614-6282
Phone
(949) 861-8600
NPI assigned
Jul 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 304252 CA Primary

Addresses

Primary practice location

17332 Von Karman Ave Ste 120
Irvine, CA 92614-6282

Mailing address

26038 Redoak St
Menifee, CA 92584-3823
Phone (323) 482-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905002633 CA Practitioner - Physical Therapist in Private Practice 0941663140 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304252CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Impt, Inc. Physical Therapist CurrentSince Aug 28, 2023 Accepting new patients
Ascend Laguna Woods Physical Therapy, Inc Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

17332 Von Karman Ave
Ste 120
Irvine, CA 92614
Phone (949) 861-8600

24361 El Toro Rd
Ste 140
Laguna Woods, CA 92637
Phone (949) 540-7560

Organizations & group practices 2

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": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1225718463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26038 REDOAK ST",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925843823",
            "telephone_number": "323-482-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17332 VON KARMAN AVE STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146282",
            "telephone_number": "949-861-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "LILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.