Kenneth Ly, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P0068 Issued in TX

Practice address

11322 Bellaire Blvd Ste 117
Generation Medical Clinic
Houston, TX 77072

Phone

(714) 757-6651

Fax

(281) 879-1809

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Family Practice

Education

College of Osteo Med of the Pacific at Pomona, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Crescent Oasis Medical PLLC

  • Clinic/Center
  • Carrollton, TX
  • NPI 1871309617
  Medicare reassignment
• Steven X Nguyen Inc

  • Family Medicine Physician
  • Houston, TX
  • NPI 1255945010
  NPD (past)
• Public Hospital District 2 of Snohomish County

  • Pain Clinic/Center
  • Edmonds, WA
  • NPI 1407167513
  NPD (past)
• Roosevelt Medical Center Trust

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1215973144
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1801909056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2993 MILLICENT WAY",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911074404",
            "telephone_number": "714-757-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11322 BELLAIRE BLVD STE 117",
            "address_2": "GENERATION MEDICAL CLINIC",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77072",
            "telephone_number": "714-757-6651",
            "fax_number": "281-879-1809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6112 Bellaire Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770814913",
            "country_code": "US",
            "telephone_number": "281-879-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LY",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "TX",
            "license": "P0068",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001670",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P0068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124254",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jannis Ly
• Joann Ly, PSY.D
• John Ly, DPT
• Julie Ly
• Katherine Ly
• Linda Lan Anh Ly, M.D.
• Nancy Theresa Ly
• Natalie Ly
• Ngan Ly, RD
• Peter Danh Ly, M.D.

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.