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CLARENCE LY NP
NPI 1356154595
Nurse Practitioner in Upland, CA

Active since January 30, 2025PECOS EnrolledAccepts Medicare Assignment
914 W FOOTHILL BLVD STE B, UPLAND, CA 91786(909) 982-8944(909) 985-0932 Get Directions Write a Review

NPPES record last updated: March 13, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Clarence Ly Np NPPES

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

CLARENCE LY NP (NPI 1356154595) is an individual nurse practitioner in Upland, California, licensed in California (NP95031960) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Rancho Cucamonga, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1356154595
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameCLARENCE LYCredential: NP
Location Address914 W FOOTHILL BLVD STE BUpland, CA 91786-3785
Mailing Address914 W Foothill Blvd Ste BUpland, CA 91786-3785 · (909) 982-8944
Phone(909) 982-8944
Fax(909) 985-0932
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 30, 2025
Last NPPES UpdateMarch 13, 2025
NPPES CertifiedMarch 13, 2025
✔ NPI 1356154595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · NP95031960
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
914 W FOOTHILL BLVD STE B, Upland, CA 91786
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Secondary Practice Location 1

Location 19190 Haven Ave Ste 102Rancho Cucamonga, CA 91730-5431 · Phone (909) 981-0989 · Fax (909) 948-9110

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

Clarence Ly Np 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 ID7517497886
PECOS Enrollment IDI20250217001064
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91786 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

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 Clarence Ly's NPI number?

The NPI number for Clarence Ly is 1356154595. It was assigned to this individual provider in the NPPES registry on January 30, 2025.

Where is Clarence Ly located?

Clarence Ly practices at 914 W Foothill Blvd Ste B, Upland, CA 91786. The listed phone number is (909) 982-8944.

What is Clarence Ly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Clarence Ly enrolled in Medicare?

Yes. Clarence 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.

When was this NPI record last updated?

The NPPES record for Clarence Ly was last updated on March 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.