Individual provider Active NPI

Carman Ly, PA-C

  • Physician Assistant
  • Oxnard, CA
National Provider Identifier
1750272191
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66671 Issued in CA
Practice address
1600 N Rose Ave
Oxnard, CA 93030-3722
Phone
(805) 988-2500
NPI assigned
Jul 14, 2025
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA66671 CA Primary

Addresses

Primary practice location

1600 N Rose Ave
Oxnard, CA 93030-3722

Mailing address

4753 Muscatel Ave
Rosemead, CA 91770-1242
Phone (626) 782-3412

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250930002751 CA Practitioner - Physician Assistant 4082110978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Powell St
Emeryville, CA 94608-1826

2100 Powell St
Suite 400
Emeryville, CA 94608-1872

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA66671CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Aug 18, 2025 Accepting new patients
Cep America-California CurrentSince Aug 18, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1750272191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 MUSCATEL AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701242",
            "telephone_number": "626-782-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N ROSE AVE",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303722",
            "telephone_number": "805-988-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "CARMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.