NPIMap

Individual provider Active NPI

Catherine Louise Ly, D.O.

  • Gastroenterology Physician
  • Cleveland, OH
National Provider Identifier
1750523783
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
34.013947 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-1143
Phone
(216) 444-2200
NPI assigned
Apr 6, 2009
Last updated
Jul 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036.129366 IL
Gastroenterology Physician 207RG0100X 34.013947 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-1143

Mailing address

21495 Avalon Dr
Rocky River, OH 44116-1125
Phone (937) 974-2036

Other practice location 1

1775 W Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190723002771 OH Practitioner - Gastroenterology 5395055248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

703 Tyler St
Suite 151
Sandusky, OH 44870-3392
Phone (419) 627-0207

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy155
Upper gastrointestinal (GI) endoscopy for acid reflux193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.129366ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince Apr 1, 2024 Accepting new patients
North Coast Professional Company, LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

703 Tyler St
Ste 151
Sandusky, OH 44870
Phone (419) 627-0207

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

Interoperability endpoints

  • Direct secure messaging: catherine.ly@fpg.medicity.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1750523783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21495 AVALON DR",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441161125",
            "telephone_number": "937-974-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441951143",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 W Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-6200",
            "fax_number": "847-696-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "CATHERINE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.129366",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "34.013947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.