CUONG PHU LY M.D.
NPI 1306883053
Internal Medicine - Nephrology in Laguna Hills, CA

Q: What is Cuong Ly's NPI number?

The NPI number for Cuong Ly is 1306883053. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Q: What is Cuong Ly's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Cuong Ly was last updated on November 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 01, 2006PECOS EnrolledAccepts Medicare Assignment

24221 CALLE DE LA LOUISA, SUITE 300, LAGUNA HILLS, CA 92653(949) 707-1059(949) 465-8159 Get Directions Write a Review

NPPES record last updated: November 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 23, 2025, Sep 3, 2025 (2 updates tracked since 2025).

On this page

About Cuong Phu Ly M.d. NPPES

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

CUONG PHU LY M.D. (NPI 1306883053) is an individual nephrology provider in Laguna Hills, California, licensed in California (A73873) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (1999).

NPPES Registry Identity

NPI1306883053

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameCUONG PHU LYCredential: M.D.

Location Address24221 CALLE DE LA LOUISA, SUITE 300Laguna Hills, CA 92653-7638

Mailing AddressPo Box 35380, Suite 400Las Vegas, NV 89133-5380 · (702) 579-3203

Phone(949) 707-1059

Fax(949) 465-8159

Sole ProprietorNo

Medical School CMSTufts University School Of MedicineGraduated 1999

Enumeration DateJune 1, 2006

Last NPPES UpdateNovember 23, 20252 updates tracked since enumeration

NPPES CertifiedNovember 23, 2025

✔ NPI 1306883053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in CA · A73873

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

24221 CALLE DE LA LOUISA, Laguna Hills, CA 92653

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Cuong Phu Ly M.d. 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.

PECOS PAC ID9739100421

PECOS Enrollment IDI20051208001001

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Cuong Ly reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Saddleback Medical Group Inc

Same address

Gastroenterology

24221 CALLE DE LA LOUISA, SUITE 400
Laguna Hills, CA 92653

Reassigned Medicare billing, California enrollment
86 clinicians in this Medicare group

NPI 1386605822 (949) 465-8155

Cuong Ly MD Inc

Same address

Nephrology

24022 CALLE DE LA PLATA STE 510
Laguna Hills, CA 92653

Reassigned Medicare billing, California enrollment

NPI 1831046499 (949) 345-1114

Healthcare Partners Affiliates Medical Group

11 mi

Addiction Medicine

14591 NEWPORT AVE
Tustin, CA 92780

Reassigned Medicare billing, California enrollment
2,052 clinicians in this Medicare group

NPI 1891981502 (714) 442-4864

Kevin Pham, M.D., Inc

15 mi

Nephrology

500 S MAIN ST STE 101
Orange, CA 92868

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Kevin Pham MD Inc
8 clinicians in this Medicare group

NPI 1578740775 (714) 836-4204

Memorialcare Medical Foundation

16 mi

Clinic/Center

17360 BROOKHURST ST
Fountain Valley, CA 92708

Reassigned Medicare billing, California enrollment
948 clinicians in this Medicare group

NPI 1205167350 (877) 696-3622

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

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

224 services99 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

194 services103 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

100 services53 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

76 services62 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

57 services57 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

33 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92653 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

29%70 patients2/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

38%224 patients2/55-star benchmark: 85%

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

100%85 patients5/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

71%1,825 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

92%709 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

7%446 patients1/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

95%276 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

58%337 patients3/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

30%446 patients2/55-star benchmark: 90%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

19%423 patients1/55-star benchmark: 88%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 73% · 470 patients

Patients tobacco: 71% · 470 patients

71%470 patients3/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

85%337 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

27%337 patients2/55-star benchmark: 79%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 892 patients

3%892 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

4 suppliers41 claims3,315 services$0.31 avg. paid by Medicare

Mycophenolate mofetil, oral, 250 mg J7517

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers27 claims4,170 services$0.20 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers17 claims2,070 services$0.90 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

4 suppliers29 claims29 services$18.30 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

5 suppliers51 claims67 services$12.62 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

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

DR. KIMVIR S DHILLON MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

24221 CALLE DE LA LOUISA, SUITE 300
LAGUNA HILLS, CA 92653

Orange County (949) 465-8145

DR. JAMES M TRENBEATH MD

Internal Medicine (Gastroenterology)

24221 CALLE DE LA LOUISA, SUITE 300
LAGUNA HILLS, CA 92653

Orange County (949) 770-7163

DR. MARK D SHIELDS MD

Internal Medicine

24221 CALLE DE LA LOUISA, SUITE 200
LAGUNA HILLS, CA 92653

Orange County (949) 588-8700

SADDLEBACK MEDICAL GROUP INC

Internal Medicine (Gastroenterology)

24221 CALLE DE LA LOUISA, SUITE 400
LAGUNA HILLS, CA 92653

Orange County (949) 465-8155

DR. NATHANIEL DAT HO M.D.

Internal Medicine (Nephrology)

24221 CALLE DE LA LOUISA, SUITE 300
LAGUNA HILLS, CA 92653

Orange County (949) 707-1059

CATHERINE BAO NGO M.D.

Internal Medicine (Gastroenterology)

24221 CALLE DE LA LOUISA, SUITE 300
LAGUNA HILLS, CA 92653

Orange County (949) 770-7163

DR. CECILIA H TRAN MD

Internal Medicine

24221 CALLE DE LA LOUISA, SUITE 200
LAGUNA HILLS, CA 92653

Orange County (949) 420-5980

DR. ARTHUR J DAIGNEAULT MD

Internal Medicine

24221 CALLE DE LA LOUISA, SUITE 200
LAGUNA HILLS, CA 92653

Orange County (949) 588-8700

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 Cuong Ly's NPI number?

The NPI number for Cuong Ly is 1306883053. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Cuong Ly located?

Cuong Ly practices at 24221 Calle De La Louisa Suite 300, Laguna Hills, CA 92653. The listed phone number is (949) 707-1059.

What is Cuong Ly's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Cuong Ly enrolled in Medicare?

Yes. Cuong 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.

Which organizations bill Medicare for Cuong Ly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Cuong Ly reassigns Medicare benefits to 5 organizations: Saddleback Medical Group Inc (Laguna Hills, CA), Cuong Ly MD Inc (Laguna Hills, CA), Healthcare Partners Affiliates Medical Group (Tustin, CA), Kevin Pham, M.D., Inc (Orange, CA) and Memorialcare Medical Foundation (Fountain Valley, CA). Each 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 Cuong 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 Cuong Ly was last updated on November 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.