Karrie VI Ly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA58701 Issued in CA

Practice address

1800 N California St
Stockton, CA 95204-6019

Phone

(209) 467-6363

NPI assigned

Jul 8, 2020

Last updated

Dec 20, 2020By the provider in NPPES

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Mid West Medical College, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aria Vascular a Professional Medical CorporationGroup PAC ID 6204350093, 10 clinicians

Advanced Radiology and Interventional Associates IncGroup PAC ID 2163816448, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Dameron Hospital Hospital, Stockton, CA, CCN 050122

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1669123626
  Medicare reassignment Care Compare group
• Aria Vascular a Professional Medical Corporation

  • Clinic/Center
  • Stockton, CA
  • NPI 1164260741
  Medicare reassignment Care Compare group
• Authority Vascular Surgery Incorporated

  • Vascular Surgery Physician
  • Stockton, CA
  • NPI 1730983131
  NPD (past)
• Port City Operating Company, LLC

  • Home Health Agency
  • Stockton, CA
  • NPI 1306978945
  NPD (past)
• Universal Radiology Consultants PC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1689606188
  NPD (past)

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

• Dameron Hospital Association

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1538163886
  Care Compare affiliation
• Dameron Hospital Association

  • Primary Care Clinic/Center
  • Stockton, CA
  • NPI 1699195115

  Hospital

  Care Compare affiliation
• Port City Operating Company, LLC

  dba St. Joseph's Medical Center of Stockton

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1598383382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-467-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "KARRIE",
        "middle_name": "VI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Lvy
• Alex Chengchee Ly, LCSW
• Giao Ngoc Ly, D.D.S
• Jessica Ly
• Johnny Ly, PT, DPT
• Katrina Ly, PHARMD
• Kelly Ly
• Kim-Oanh Ly, M.D.
• Lynda D. Winter
• Corina Lyons

• Physician Assistant in Stockton, CA
• Providers in Stockton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; 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.