Amanda Van Ly, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101024118 Issued in MI

Practice address

584 N Sunrise Ave Ste 100
Roseville, CA 95661-2862

Phone

(916) 250-2596

Fax

(916) 550-5025

NPI assigned

Jul 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

General Surgery

Education

West Virginia School of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sierra Medical PartnershipGroup PAC ID 7810321858, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Folsom Hospital, Folsom, CA, CCN 050414
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aly663652@hisp.ehr.sutterhealth.org
• Direct secure messaging: amanda.ly.1@21842.direct.athenahealth.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.

• Sierra Medical Partnership

  • Surgery Physician
  • Folsom, CA
  • NPI 1568015808
  Medicare reassignment Care Compare group NPD
• Sierra Medical Partnership

  • Surgery Physician
  • El Dorado Hills, CA
  • NPI 1801502679
  NPD
• Sierra Nevada Memorial-Miners Hospital

  dba Sierra Nevada Memorial Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  NPD (past)

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

• Dignity Health

  dba Mercy Hospital of Folsom

  • General Acute Care Hospital
  • Folsom, CA
  • NPI 1356389878
  Care Compare affiliation
• Dignity Health

  dba Mercy General Hospital

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation
• Sutter Valley Hospitals

  dba Sutter Roseville Medical Center

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1417443334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 CREEKSIDE DR STE 202",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303819",
            "telephone_number": "916-663-2100",
            "fax_number": "916-663-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 N SUNRISE AVE STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612862",
            "telephone_number": "916-250-2596",
            "fax_number": "916-550-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "AMANDA",
        "middle_name": "VAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101024118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Luviano, APCC
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• Myo Thet Lwin, MD
• Dung Ly
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• Rawlings Everett Lyle, MD MAS
• Galyna Lymar, RDH
• Racquel L Lymos

• Surgery Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.