Van B. Ly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

60013431 Issued in WA

Practice address

319 7TH Ave SE
Suite #101
Olympia, WA 98501-1325

Phone

(360) 357-2544

Fax

(360) 786-8734

NPI assigned

Aug 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Van B Ly-Reyes Other name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Van B Ly LLCGroup PAC ID 7416021639, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@vanblyodllcolympiawa.compulinkdirect.com

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.

• Van B. Ly, LLC

  • Clinic/Center
  • Olympia, WA
  • NPI 1154585024
  Medicare reassignment Care Compare group NPD Authorized official
• Ken P Lee MD PLLC

  • Internal Medicine Physician
  • Olympia, WA
  • NPI 1689778979
  NPD
• Pacific University

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1912377193
  NPD (past)

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

{
    "created_epoch": "1186790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1386836591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 7TH AVE SE",
            "address_2": "SUITE #101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011325",
            "telephone_number": "360-357-2544",
            "fax_number": "360-786-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 7TH AVE SE",
            "address_2": "SUITE #101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011325",
            "telephone_number": "360-357-2544",
            "fax_number": "360-786-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "VAN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-11",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3211ATI",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60013431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VAN",
            "last_name": "LY-REYES",
            "middle_name": "B",
            "prefix": "DR.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Luxottica Retail North America Inc
• Rachel Emma Luymes, RD
• Vincent Luzentales
• Chan Ly
• Lien Hong Ly, D.O.
• Stephen D. Lykins, MD
• Patricia Denise Lynch, ARNP, FNP-BC
• Percy Lee Lynchard III, ARNP
• Lynn M Okita Arnp PLLC
• Valerie A Lynn, M.A., L.M.H.C.

• Optometrist in Olympia, WA
• Providers in Olympia, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.