NPIMap

Individual provider Active NPI

Thomas C Ly, MD

  • Family Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1891007787
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45537 Issued in AZ
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 854-0002
Fax
(928) 453-0885
NPI assigned
Jul 8, 2010
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 45537 AZ Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

13236 N 7TH St
Ste 4- 255
Phoenix, AZ 85022-5343
Phone (928) 854-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20111227000084 AZ Practitioner - HospitalistPractitioner - Family PracticePractitioner - Emergency Medicine 8224204110 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group IncGroup PAC ID 2961314265, 85 clinicians
La Paz Regional Hospital IncGroup PAC ID 1557273356, 50 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 855-8185

1200 W Mohave Rd
Parker, AZ 85344-6349
Phone (928) 669-7382

1713 S Kofa Ave
Suite a
Parker, AZ 85344-6401
Phone (928) 669-7380

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.61 of 100Reported as group
Quality
100
Improvement activities
40
Cost
88.22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
La Paz Regional Hospital Inc Current Accepting new patients
La Paz Regional Hospital, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Apogee Medical Group Inc CurrentSince May 11, 2013 Accepting new patients
Comprehensive Hospitalist Services of Arizona, LLC CurrentSince Jul 1, 2015 Accepting new patients
La Paz Regional Hospital Inc CurrentSince Jul 1, 2022 Accepting new patients
Comprehensive Hospitalist Services of Arizona LLC CurrentSince Jul 1, 2015 Accepting new patients
Apogee Medical Group Inc CurrentSince May 11, 2013 Accepting new patients
Polaris Medical Group LLC Past Accepting new patients
Havasu Regional Medical Center LLC Past Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1301 S Crismon Rd
Mesa, AZ 85209
Phone (480) 358-6300

1200 W Mohave Rd
Parker, AZ 85344
Phone (928) 669-7300

1713 S Kofa Ave
Ste A
Parker, AZ 85344
Phone (928) 669-7380

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

Interoperability endpoints

  • Direct secure messaging: thomasly@lprh.medalliesdirect.net

Organizations & group practices 9

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 5

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1891007787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13236 N 7TH ST",
            "address_2": "STE 4- 255",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225343",
            "telephone_number": "928-854-0002",
            "fax_number": "928-453-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-854-0002",
            "fax_number": "928-453-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "45537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.