Amanda Ly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT34702-TLG Issued in CA

Practice address

43927 15TH St W
Lancaster, CA 93534-4758

Phone

(661) 948-6310

NPI assigned

Sep 28, 2020

Sex

Female

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Fourth Optometric Care of CaliforniaGroup PAC ID 6305210345, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fourth Optometric Care of California

  • Optometrist
  • Mountain View, CA
  • NPI 1497499974
  Medicare reassignment Care Compare group
• Damon Matthew Ellis, O.D.

  • Optometrist
  • Oakland, CA
  • NPI 1023231917
  Medicare reassignment
• Fourth Optometric Care of California

  • Optometrist
  • Mountain View, CA
  • NPI 1689248874
  NPD
• Fourth Optometric Care of California

  • Optometrist
  • Carlsbad, CA
  • NPI 1952019614
  NPD
• Damon Matthew Ellis

  • Optometrist
  • Lancaster, CA
  • NPI 1447091038
  NPD (past)
• Ellis Eye Optometry

  • Optometrist
  • Lancaster, CA
  • NPI 1932924180
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1902413495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 HIGHLANDER RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928335508",
            "telephone_number": "714-515-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43927 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344758",
            "telephone_number": "661-948-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34702-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latonia Luu, PHARM.D.
• Mindy Luu, RPH
• Luxe Derm Aesthetics
• Luxottica of America Inc.
• Mikhail Lvovich
• Britney Okalani Ly
• Thaovari Thi Ly, OTR/L
• Olga Lyass, M.D.
• Lydia Green MD Inc
• Lydia'S Medical Nutrition Therapy

• Optometrist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.