Peter N. Ly, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

E3804 Issued in CA

Practice address

7717 N. Orange Prairie Road
Peoria, IL 61615

Phone

(619) 518-1506

Fax

(309) 589-6994

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1447254396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7717 N. ORANGE PRAIRIE ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "619-518-1506",
            "fax_number": "309-589-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 N. ORANGE PRAIRIE ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "619-518-1506",
            "fax_number": "309-589-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "PETER",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E3804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E38040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lutz Physical Medicine Corp
• Angela Gail Lutz
• Jenessa Kalene Lutz, D.C.
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Daniel Richard Lygrisse, D.O.
• Ashley Lyle, LCSW
• Teresa Lynch, M.D.
• Lynne M Jalovec, MD, SC
• Cheryl Renee Lyons, RN BSN

• Foot Surgery Podiatrist in Peoria, IL
• Providers in Peoria, IL by specialty
• Foot Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.