Organization Active NPI

Ly Family Medicine Hicksville

  • Family Medicine Physician
  • Hicksville, NY
National Provider Identifier
1336011485
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LY FAMILY MEDICINE HICKSVILLE
Practice address
101 Jerusalem Ave
Hicksville, NY 11801-4951
Phone
(516) 681-0681
NPI assigned
Sep 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Dr. Liyan Yao, MDNPI 1427799832
Title
Owner
Phone
(631) 882-1689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

101 Jerusalem Ave
Hicksville, NY 11801-4951

Mailing address

36 Hilltop Dr
Syosset, NY 11791-2003
Phone (631) 882-1689

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251119000204 NY Part B Supplier - Clinic/Group Practice 5496246381 Receives reassigned benefits from 1 practitioner
Practice locations: Hicksville, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2334263Ly Family Medicine Hicksville101 Jerusalem Ave, Suite 1, Hicksville, NY 11801Certificate of waiverNov 17, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1336011485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HILLTOP DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117912003",
            "telephone_number": "631-882-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JERUSALEM AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014951",
            "telephone_number": "516-681-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LY FAMILY MEDICINE HICKSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "YAO",
        "authorized_official_first_name": "LIYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-882-1689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.