Organization Active NPI

Ae & Ly Medical Associates PLLC

  • Gastroenterology Physician
  • Flushing, NY
National Provider Identifier
1912060229
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
204609 Issued in NY
Legal business name
AE & LY MEDICAL ASSOCIATES PLLC
Practice address
13633 37TH Ave FL 7
Flushing, NY 11354-4561
Phone
(718) 321-3262
Fax
(718) 321-3263
NPI assigned
Dec 18, 2006
Last updated
Mar 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Sally Chu
Title
Medical Billing Specialist
Phone
(718) 321-3262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 204609 NY
Gastroenterology Physician 207RG0100X 204609 NY Primary

Addresses

Primary practice location

13633 37TH Ave FL 7
Flushing, NY 11354-4561

Mailing address

13633 37TH Ave FL 7
Flushing, NY 11354-4561
Phone (718) 321-3262

Other identifiers 2

IdentifierTypeStateIssuer
07932OtherNYGHI MEDICARE GROUP NUMBER
02163642MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070710000162 NY Part B Supplier - Clinic/Group Practice 7810999539 Receives reassigned benefits from 12 practitioners
Practice locations: Huntington, NY; Hicksville, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

16 E John St
#16
Hicksville, NY 11801
Phone (516) 938-3388

16 E John St
Ste 16
Hicksville, NY 11801

33 Walt Whitman Rd
Ste 217
Huntington Station, NY 11746
Phone (631) 271-5070

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1912060229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13633 37TH AVE FL 7",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544561",
            "telephone_number": "718-321-3262",
            "fax_number": "718-321-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13633 37TH AVE FL 7",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544561",
            "telephone_number": "718-321-3262",
            "fax_number": "718-321-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AE & LY MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "718-321-3262"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "204609",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "204609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE GROUP NUMBER",
            "identifier": "07932",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02163642",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.