Individual provider Active NPI

Nghi Ly, DPT

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1306246517
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25130 Issued in MD
Practice address
3165 Crain Hwy Ste 100
Waldorf, MD 20603-4847
Phone
(301) 885-2500
Fax
(410) 313-8314
NPI assigned
Aug 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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 25130 MD Primary

Addresses

Primary practice location

3165 Crain Hwy Ste 100
Waldorf, MD 20603-4847

Mailing address

PO Box 419666
Boston, MA 02241-9666
Phone (410) 970-8190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241218002237 MD Practitioner - Physical Therapist in Private Practice 0143757989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sage Physical Therapy and Wellness LLCGroup PAC ID 4789860131, 24 clinicians

Practice addresses (Care Compare)

22599 Macarthur Blvd
Suite 106
California, MD 20619-3081
Phone (301) 737-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Active Physical Therapy Services, LLC Physical Therapist PastSince Jul 28, 2019 Accepting new patients

Locations

22599 MacArthur Blvd
Ste 106
California, MD 20619
Phone (301) 737-3400

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1306246517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419666",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022419666",
            "telephone_number": "410-970-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 CRAIN HWY STE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034847",
            "telephone_number": "301-885-2500",
            "fax_number": "410-313-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "NGHI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.