Individual provider Active NPI

Nam Thanh Ly, M.D.

  • Pulmonary Disease Physician
  • Portsmouth, VA
National Provider Identifier
1780655837
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
01054164A Issued in IN
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 953-2266
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101245794 VA
Pulmonary Disease Physician 207RP1001X 0101245794 VA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01054164A IN
Sleep Medicine (Internal Medicine) Physician 207RS0012X 0101245794 VA
Pulmonary Disease Physician 207RP1001X 01054164A IN Primary

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-2266

Other practice location 1

600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904
Phone (757) 388-6115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20120215000027 VA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2961660394 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101245794VAMDCritical Care Medicine (Internal Medicine) Physician
01054164AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Pulmonary Disease CurrentSince May 16, 2022 Accepting new patients
Bayview Physician Services, PC Critical Care Medicine CurrentSince Jan 16, 2012 Accepting new patients
Bayview Physician Services, PC CurrentSince Jan 16, 2012 Accepting new patients

Locations

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

600 Gresham Dr
Ste 8630B
Norfolk, VA 23507
Phone (757) 338-6115

1168 First Colonial Rd
Ste 101
Virginia Beach, VA 23454
Phone (757) 481-2515

Interoperability endpoints

  • Direct secure messaging: nly44518@direct.sentara.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospital for Extended RecoveryNorfolk, VA, CCN 492007 Hospital Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1780655837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Gresham Dr Ste 8630B",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-6115",
            "fax_number": "757-275-9998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "NAM",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101245794",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101245794",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01054164A",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "VA",
            "license": "0101245794",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01054164A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.