Individual provider Active NPI

Tri Ly, MD

  • Internal Medicine Physician
  • Hemet, CA
National Provider Identifier
1356923957
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
191632 Issued in CA
Practice address
1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone
(951) 652-2811
NPI assigned
Apr 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 191632 CA Primary

Addresses

Primary practice location

1117 E Devonshire Ave
Hemet, CA 92543-3083

Mailing address

1117 E Devonshire Ave
Hemet, CA 92543-3083
Phone (951) 652-2811

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
I20240328003458 CA Practitioner - Internal Medicine 9830537620 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
191632CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Star Medical Group Inc. Internal Medicine CurrentSince Nov 8, 2024 Accepting new patients
Seven Star Medical Group Inc. CurrentSince Nov 8, 2024 Accepting new patients
Seven Star Medical Group Inc. Current Accepting new patients

Locations

1515 W Florida Ave
Hemet, CA 92543
Phone (951) 929-1333

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

41889 State Highway 74
Hemet, CA 92544
Phone (951) 652-8700

28400 McCall Blvd
Ste B10
Menifee, CA 92585
Phone (951) 414-2020

29826 Haun Rd
Menifee, CA 92586

29826 Haun Rd
Ste 200
Sun City, CA 92586
Phone (951) 237-8304

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1356923957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-652-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E DEVONSHIRE AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433083",
            "telephone_number": "951-652-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "TRI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "191632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.