Active NPI
Bao-Khuyen Nguyen Ly, PA-C
- Medical Physician Assistant
- Largo, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9112468
- Practice address
- 13670 Walsingham Rd
Largo, FL 33774-3532 - Phone
- (727) 593-9848
- NPI assigned
- Nov 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9112468 | FL | Primary |
Addresses
Primary practice location
13670 Walsingham Rd
Largo, FL 33774-3532
Mailing address
11921 N Dale Mabry Hwy
Tampa, FL 33618-3512
Phone (813) 609-3635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108286600 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | BaoKhuyen.Nguyen@direct.mybaycare.org | Health Information Exchange (HIE) | BayCare Urgent Care, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200212000524 | FL | Practitioner - Physician Assistant | 6901232818 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baycare Urgent Care, LLC.
Practice addresses (Care Compare)
1155 S Dale Mabry Hwy
Tampa, FL 33629-5035
Phone (813) 609-3666
13670 Walsingham Rd
Largo, FL 33774-3532
Phone (727) 593-9848
17512 Dona Michelle Dr
Tampa, FL 33647-3265
Phone (813) 533-3494
18610 Fernview St
Land O Lakes, FL 34638-6212
Phone (813) 692-8080
2331 4TH St N
St Petersburg, FL 33704-2801
Phone (727) 914-8566
2442 Bloomingdale Ave
Valrico, FL 33596-6403
Phone (813) 586-8686
3351 N McMullen Booth Rd
Clearwater, FL 33761-2014
Phone (727) 314-4774
3440 W Dr MLK Blvd
Suite 100
Tampa, FL 33607-6223
Phone (813) 559-1888
36245 Hwy 27
Haines City, FL 33844-3744
Phone (863) 866-9933
4821 US Hwy 19
Suite 5
New Port Richey, FL 34652-4259
Phone (727) 851-9650
Hospital & facility affiliations
- St Josephs Hospital
- Morton Plant Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9112468 | FL | MD | Medical Physician Assistant |
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Medical Group, Inc. | Current | Accepting new patients | |
| Baycare Urgent Care, LLC | Current | Accepting new patients | |
| Healthnow Urgent Care, L.L.C. | Past | Accepting new patients |
Locations
2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234
2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060
2995 Drew St
Fl 3
Clearwater, FL 33759
13670 Walsingham Rd
Largo, FL 33774
Phone (727) 593-9848
4821 US Highway 19
Ste 5
New Port Richey, FL 34652
Phone (727) 851-9650
6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300
2331 4th St N
St Petersburg, FL 33704
Phone (727) 593-9848
11921 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 609-3635
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Clearwater, FL
- NPI 1659720837
-
- Urgent Care Clinic/Center
- Clearwater, FL
- NPI 1942512850
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Clearwater, FL
- NPI 1376529743
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681689600000",
"number": "1972149672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11921 N DALE MABRY HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336183512",
"telephone_number": "813-609-3635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13670 WALSINGHAM RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337743532",
"telephone_number": "727-593-9848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "BAO-KHUYEN",
"middle_name": "NGUYEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-18",
"last_updated": "2023-04-17",
"certification_date": "2023-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9112468",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "108286600",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "BaoKhuyen.Nguyen@direct.mybaycare.org",
"affiliation": "Y",
"affiliationName": "BayCare Urgent Care, LLC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2995 Drew St Fl 2",
"city": "Clearwater",
"state": "FL",
"country_code": "US",
"postal_code": "337593012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.