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MALICA LY
NPI 1083222988
Audiologist in Santa Rosa, CA

Active since July 16, 2020
4725 HOEN AVE STE B, SANTA ROSA, CA 95405(707) 542-1154(707) 542-4818 Get Directions Write a Review

NPPES record last updated: July 17, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Malica Ly NPPES

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

MALICA LY (NPI 1083222988) is an individual audiologist in Santa Rosa, California, licensed in California (13592) and active in the NPI registry since July 2020. She maintains a secondary practice location in Healdsburg.

NPPES Registry Identity

NPI1083222988
Entity TypeIndividualFemale
Primary Taxonomy231H00000X
Provider Legal NameMALICA LY
Location Address4725 HOEN AVE STE BSanta Rosa, CA 95405-9405
Mailing Address750 N Commons Dr Ste 200Aurora, IL 60504-7940 · (630) 303-5380 · Fax (630) 303-5385
Phone(707) 542-1154
Fax(707) 542-4818
Sole ProprietorNo
Enumeration DateJuly 16, 2020
Last NPPES UpdateJuly 17, 2020
NPPES CertifiedJuly 17, 2020
✔ NPI 1083222988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers
Taxonomy Code231H00000X
License✔ Licensed in CA · 13592
Definition
(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.
4725 HOEN AVE STE B, Santa Rosa, CA 95405
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Secondary Practice Location 1

Location 11260 Healdsburg Ave Ste 202Healdsburg, CA 95448-3409 · Phone (707) 433-0705 · Fax (707) 433-0705

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Malica Ly is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Malica Ly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
31 mi
Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1336222397 (707) 651-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELE MORELAND HAD
Hearing Instrument Specialist
4725 HOEN AVE STE B
SANTA ROSA, CA 95405
Sonoma County (707) 542-1154
MR. ROBERT WILLIAM RAPPAPORT
Hearing Instrument Specialist
4725 HOEN AVE STE B
SANTA ROSA, CA 95405
Sonoma County (707) 542-1154
HARVEY SPARKS
Hearing Instrument Specialist
4725 HOEN AVE STE B
SANTA ROSA, CA 95405
Sonoma County (707) 542-1154
RENE L MORTEN
Hearing Instrument Specialist
4725 HOEN AVE STE B
SANTA ROSA, CA 95405
Sonoma County (707) 542-1154
MICHAEL FRANCIS MULVEY
Hearing Instrument Specialist
4725 HOEN AVE STE B
SANTA ROSA, CA 95405
Sonoma County (707) 542-1154

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 Malica Ly's NPI number?

The NPI number for Malica Ly is 1083222988. It was assigned to this individual provider in the NPPES registry on July 16, 2020.

Where is Malica Ly located?

Malica Ly practices at 4725 Hoen Ave Ste B, Santa Rosa, CA 95405. The listed phone number is (707) 542-1154.

What is Malica Ly's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is Malica Ly enrolled in Medicare?

Yes. Malica Ly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Malica Ly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Malica Ly reassigns Medicare benefits to Permanente Medical Group Inc (Vallejo, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Malica Ly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Malica Ly was last updated on July 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.