NPIMap

Individual provider Active NPI

Andrew J Ly, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1447712302
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036160798 Issued in IL
Practice address
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone
(773) 665-6730
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036160798 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr
Chicago, IL 60657-5640

Mailing address

1229 W Kelly St
Arlington Heights, IL 60004-8432
Phone (847) 899-0819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220822001373 IL Practitioner - Family Practice 0244613446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

351 Delnor Dr
Geneva, IL 60134-4222
Phone (630) 923-9600

Hospital & facility affiliations

  • Resilience Home Health, LLC Home health agency, Aurora, IL, CCN 147998
  • DMJ Home Health Services, Inc Home health agency, Aurora, IL, CCN 147997
  • Astra Health West Home health agency, Elgin, IL, CCN 148172
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 1, 2022 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

351 Delnor Dr
Ste 100
Geneva, IL 60134
Phone (630) 938-9900

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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 8

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1447712302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 W KELLY ST",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600048432",
            "telephone_number": "847-899-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "IL",
            "license": "036160798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.