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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KELLY LY
NPI 1003715756
Physician Assistant in San Jose, CA

Active since October 31, 2026
1371 GOLDENLAKE RD, SAN JOSE, CA 95131(669) 260-4354 Get Directions Write a Review

NPPES record added: October 31, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelly Ly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY LY (NPI 1003715756) is an individual physician assistant in San Jose, California and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1003715756
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY LY
Location Address1371 GOLDENLAKE RDSan Jose, CA 95131-2525
Mailing Address1371 Goldenlake RdSan Jose, CA 95131-2525
Phone(669) 260-4354
Sole ProprietorNo
Enumeration DateOctober 31, 2026
NPPES CertifiedOctober 30, 2026
✔ NPI 1003715756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1371 GOLDENLAKE RD, San Jose, CA 95131
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Ly's NPI number?

The NPI number for Kelly Ly is 1003715756. It was assigned to this individual provider in the NPPES registry on October 31, 2026.

Where is Kelly Ly located?

Kelly Ly practices at 1371 Goldenlake Rd, San Jose, CA 95131. The listed phone number is (669) 260-4354.

What is Kelly Ly's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Kelly Ly was last updated on October 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.