Individual provider Active NPI

Hongdu K. Ly, D.O.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1972740942
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11259 Issued in CA
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(877) 866-7123
NPI assigned
Jan 13, 2009
Last updated
Apr 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N1746 TX
Family Medicine Physician 207Q00000X 20A11259 CA Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

2821 Agua Vista Dr
San Jose, CA 95132-2104
Phone (510) 593-5672

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117000275 CA Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 0941495857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Wound Physicians of Ca PCGroup PAC ID 8527245240, 4 clinicians

Practice addresses (Care Compare)

9028 Rose St
Bellflower, CA 90706-6418
Phone (562) 925-4252

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1049
Removal of skin lesions16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11259CAMDAcupuncturist
N1746TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of Ca, P.C. Family Medicine CurrentSince Apr 22, 2013 Accepting new patients

Locations

350 Calloway Dr
Bldg C
Bakersfield, CA 93312
Phone (661) 587-0182

9028 Rose St
Bellflower, CA 90706
Phone (562) 925-4252

3806 Clayton Rd
Concord, CA 94521
Phone (925) 689-2266

12461 Springdale St
Garden Grove, CA 92845
Phone (714) 933-7560

361 E Grangeville Blvd
Hanford, CA 93230
Phone (559) 582-9221

1617 Ramirez St
Marysville, CA 95901
Phone (530) 742-4311

1275 Crane St
Menlo Park, CA 94025
Phone (510) 481-3206

180 Promenade Cir
Ste 300
Sacramento, CA 95834
Phone (916) 352-6232

180 N Jackson Ave
San Jose, CA 95116
Phone (408) 253-9034

2566 Treasure Dr
Santa Barbara, CA 93105
Phone (805) 687-0701

2280 Dockery Ave
Selma, CA 93662
Phone (559) 896-4900

9107 Davis Rd
Stockton, CA 95209
Phone (209) 478-6488

1449 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 939-5820

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1972740942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 AGUA VISTA DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322104",
            "telephone_number": "510-593-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "HONGDU",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1746",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.