Cong T Ly

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A10687 Issued in CA

Practice address

6640 Alton Parkway
Emergency Dept
Irvine, CA 92618

Phone

(714) 644-4000

NPI assigned

Jan 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Beach Emergency Medical Associates

  • Emergency Medicine Physician
  • Huntington Beach, CA
  • NPI 1013074996
  Medicare reassignment NPD
• Hollywood Presbyterian Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1972826931
  Medicare reassignment NPD
• Orange County Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • La Palma, CA
  • NPI 1508114711
  Medicare reassignment NPD
• Pacific Coast Emergency Medical Associates, Inc

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1316179492
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD
• Beach Cities Urgent Care Center

  • Urgent Care Clinic/Center
  • Playa Vista, CA
  • NPI 1700074598

  Emergency Medicine

  NPD (past)
• Emergency Physicians Medical Associates of Long Beach

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1386675015
  NPD (past)
• Gardena Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Gardena, CA
  • NPI 1497824189
  NPD (past)

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

{
    "created_epoch": "1200700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1649456682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 ALTON PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183734",
            "telephone_number": "714-644-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 ALTON PARKWAY",
            "address_2": "EMERGENCY DEPT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92618",
            "telephone_number": "714-644-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "CONG",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-19",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A10687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luxottica of America Inc
• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Coral Ly
• Elizabeth Ly, DMD
• Jennifer Ly
• Thanh-Lan Ly, NP-C
• Elizabeth Joy Lyche

• Emergency Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.