KENNETH LY
NPI 1104558170
Family Medicine in Phillipsburg, NJ
About Kenneth Ly NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH LY (NPI 1104558170) is an individual family medicine provider in Phillipsburg, New Jersey, licensed in New Jersey (25MA12797600) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS, is affiliated with St Luke's Warren Hospital, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kenneth Ly is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Luke's Warren Hospital
Acute Care Hospitals · Phillipsburg, NJSt Luke's Hospital Bethlehem
Acute Care Hospitals · Bethlehem, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 08865 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Kenneth Ly's NPI number?
The NPI number for Kenneth Ly is 1104558170. It was assigned to this individual provider in the NPPES registry on June 28, 2022.
Where is Kenneth Ly located?
Kenneth Ly practices at 200 Strykers Rd Ste 1, Phillipsburg, NJ 08865. The listed phone number is (908) 847-6568.
What is Kenneth Ly's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kenneth Ly enrolled in Medicare?
Yes. Kenneth Ly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Kenneth Ly affiliated with any hospitals?
According to CMS data, Kenneth Ly is affiliated with St Luke's Warren Hospital and St Luke's Hospital Bethlehem.
When was this NPI record last updated?
The NPPES record for Kenneth Ly was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Kenneth Ly · NPI 1104558170
Family Medicine physician in Phillipsburg, New Jersey. Individual provider, active in the CMS NPPES registry since June 28, 2022.
## Identity
- **NPI:** 1104558170 (Entity type: Individual)
- **Enumerated:** June 28, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 25MA12797600 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 STRYKERS RD STE 1, Phillipsburg, NJ 08865-9465
- **Phone:** (908) 847-6568 · **Fax:** (866) 278-3009
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** August 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104558170) · Data from the CMS NPPES public registry.