Dat Ly, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A62801 Issued in CA

Practice address

350 Hawthorne Ave
Oakland, CA 94609-3100

Phone

(510) 655-4000

Fax

(510) 869-8906

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Specialty

Anesthesiology

Education

Tufts University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ambulatory Consultants Medical Group IncGroup PAC ID 0446299184, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Ambulatory Consultants Medical Group Inc

  • Anesthesiology Physician
  • Oakland, CA
  • NPI 1437178563
  Medicare reassignment Care Compare group NPD
• East Bay Anesthesiology Medical Group, Inc

  • Anesthesiology Physician
  • Oakland, CA
  • NPI 1649226242
  Medicare reassignment NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1790791564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-655-4000",
            "fax_number": "510-869-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093100",
            "telephone_number": "510-655-4000",
            "fax_number": "510-869-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "DAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A62801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A628010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luyen V. Ta, M.D., Inc/Tuong-VI Ta, M.D.
• Joanna Luzano, RN
• Sophia Rose Luzzi, MD
• Chhoy Ly
• Christine Nguyen Ly, PHARMD
• Elizabeth Ly
• Ha Ly
• Holly Ly, PHARMD
• Jimmy Ly, PHARMD
• Mai Tu Ly, DDS

• Anesthesiology Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.