DR. PETER N. LY DPM NPI 1447254396

NPI Information

NPI: 1447254396
Provider Name: DR. PETER N. LY, DPM
Classification: Podiatrist - 213ES0131X
Entity Type: Individual

Specialization: Foot Surgery

PECOS Registration: Yes

Address:
7717 N. ORANGE PRAIRIE ROAD
PEORIA, IL
ZIP 61615
Phone: (619) 518-1506
Get Directions

DR. Peter N. Ly, DPM is a foot surgery podiatrist in Peoria, IL. DR. Peter N. Ly, DPM NPI is 1447254396. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7717 N. ORANGE PRAIRIE ROAD
PEORIA, IL
ZIP 61615
Phone: (619) 518-1506
Fax: (309) 589-6994

The NPI 1447254396 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/9/2005 and was last updated on 3/27/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	E3804	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U34546	MEDICARE UPIN	CALIFORNIA
2	E3804	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE #
3	000E38040	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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