Individual provider Active NPI

Ngoc Ly

  • Critical Care Medicine (Anesthesiology) Physician
  • Fall River, MA
National Provider Identifier
1356735401
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
282453 Issued in MA
Practice address
363 Highland Ave
Fall River, MA 02720-3703
Phone
(508) 973-7558
Fax
(508) 973-7147
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 282453 MA Primary

Addresses

Primary practice location

363 Highland Ave
Fall River, MA 02720-3703

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other practice location 1

160 Robbins St
Chase Outpatient Center
Waterbury, CT 06708-2652
Phone (203) 573-7284

Other practice location 2

160 Robbins St
Chase Outpatient Center
Waterbury, CT 06708-2652
Phone (203) 573-7284

Other identifiers 1

IdentifierTypeStateIssuer
D87066OtherMDLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nly52923@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200831000086 MA Practitioner - Anesthesiology 4284984576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Tulane University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Associates CurrentSince Jun 1, 2022 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2020 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Interoperability endpoints

  • Direct secure messaging: nly52923@direct.southcoast.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1356735401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 HIGHLAND AVE",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027203703",
            "telephone_number": "508-973-7558",
            "fax_number": "508-973-7147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Robbins St",
            "address_2": "Chase Outpatient Center",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082652",
            "country_code": "US",
            "telephone_number": "203-573-7284",
            "fax_number": "203-573-7031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Robbins St",
            "address_2": "Chase Outpatient Center",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067082652",
            "country_code": "US",
            "telephone_number": "203-573-7284",
            "fax_number": "203-573-7031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "NGOC",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MA",
            "license": "282453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D87066",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nly52923@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "363 Highland Ave",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027203703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.