Individual provider Active NPI

Peter James Ly, MD

  • Family Medicine Physician
  • Findlay, OH
National Provider Identifier
1356838494
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301505003 Issued in MI
Practice address
1900 S Main St
Findlay, OH 45840-1216
Phone
(419) 423-4500
NPI assigned
Apr 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A193415 CA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301505003 MI Primary

Addresses

Primary practice location

1900 S Main St
Findlay, OH 45840-1216

Mailing address

32010 Jefferson Ave
Saint Clair Shores, MI 48082-1365
Phone (248) 462-5821

Other practice location 1

1800 Spring Ridge Dr
Susanville, CA 96130-6100
Phone (303) 390-1940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240410002872 CA Practitioner - Family Practice 6305243197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Physicians Group PCGroup PAC ID 2062767148, 6 clinicians

Practice addresses (Care Compare)

1800 Spring Ridge Dr
Susanville, CA 96130-6100
Phone (530) 252-2000

Hospital & facility affiliations

  • Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320
  • Banner Lassen Medical Center Nursing home, CCN 05Z320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193415CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blanchard Valley Regional Health Center Family Medicine Current Accepting new patients
Rural Physicians Group, PC Family Medicine CurrentSince Mar 28, 2024 Accepting new patients

Locations

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

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.

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": "1523664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1356838494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32010 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821365",
            "telephone_number": "248-462-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S MAIN ST",
            "city": "FINDLAY",
            "state": "OH",
            "postal_code": "458401216",
            "telephone_number": "419-423-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Spring Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Susanville",
            "state": "CA",
            "postal_code": "961306100",
            "country_code": "US",
            "telephone_number": "303-390-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-14",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A193415",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301505003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Findlay, OH

Sources for this page

Verify at the official NPI Registry.