Individual provider Active NPI

John Ly, PT, DPT

  • Physical Therapist
  • Seattle, WA
National Provider Identifier
1588200323
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61290039 Issued in WA
Practice address
3043 59TH Ave SW Apt B
Seattle, WA 98116-4722
Phone
(201) 982-3344
NPI assigned
Nov 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01935900 NJ
Physical Therapist 225100000X 045270 NY
Physical Therapist 225100000X PT61290039 WA Primary

Addresses

Primary practice location

3043 59TH Ave SW Apt B
Seattle, WA 98116-4722

Mailing address

3043 59TH Ave SW Apt B
Seattle, WA 98116-4722
Phone (201) 982-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045270NYMDPharmacist
40QA01935900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jly PT, PC Physical Therapist CurrentSince Jun 22, 2021 Accepting new patients
John Ly, PT PC Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients
Fit Club Inc Physical Therapist PastSince Dec 1, 2019 Accepting new patients
Kellen Ryan Scantlebury Physical Therapy PLLC Physical Therapist PastSince Jan 16, 2025 Accepting new patients

Organizations & group practices 4

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": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1588200323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 59TH AVE SW APT B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164722",
            "telephone_number": "201-982-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 59TH AVE SW APT B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164722",
            "telephone_number": "201-982-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "JOHN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01935900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045270",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61290039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.