Van Thanh Ly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020564 Issued in CA

Practice address

200 Jose Figueres Ave Ste 180
San Jose, CA 95116-1586

Phone

(408) 876-0836

NPI assigned

Apr 5, 2022

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Asian American Home Health Home health agency, Alameda, CA, CCN 557754

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Professional Wound Specialists PC

  • Surgery Physician
  • Pomona, CA
  • NPI 1437988326
  Medicare reassignment NPD

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

• Asian American Home Care, Inc

  • Home Health Agency
  • Alameda, CA
  • NPI 1336144484
  Care Compare affiliation

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1790426781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8721 CHURCH ST",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "950204233",
            "telephone_number": "408-876-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE STE 180",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161586",
            "telephone_number": "408-876-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "VAN",
        "middle_name": "THANH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiep Ly, PHARM.D.
• Tiffany Phung Ly
• Tony Ly, CPHT
• Truman Ly
• Van T. Ly
• Lauren Tang Lym, ANP
• Kelly Sue Lynch, PHD
• Lisa Louise Lynch, DC
• Marion Alva Karalena Lynch
• Melissa Louise Lynch

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.