STANFORD LY MD
NPI 1407219330
Pediatrics in Sacramento, CA

Q: What is Stanford Ly's NPI number?

The NPI number for Stanford Ly is 1407219330. It was assigned to this individual provider in the NPPES registry on March 29, 2016.

Q: What is Stanford Ly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Stanford Ly was last updated on February 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 29, 2016PECOS Enrolled

1650 RESPONSE RD, SACRAMENTO, CA 95815(916) 443-3299 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 9, 2024, Sep 9, 2019, Apr 4, 2019 and 1 more (4 updates tracked since 2016).

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About Stanford Ly Md NPPES

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

STANFORD LY MD (NPI 1407219330) is an individual pediatrics provider in Sacramento, California, licensed in California (158084) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407219330

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameSTANFORD LYCredential: MD

Location Address1650 RESPONSE RDSacramento, CA 95815-4807

Mailing Address1650 Response RdSacramento, CA 95815-4807 · (916) 614-4060

Phone(916) 443-3299

Sole ProprietorNo

Enumeration DateMarch 29, 2016

Last NPPES UpdateFebruary 9, 20244 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2024

✔ NPI 1407219330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · 158084

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1650 RESPONSE RD, Sacramento, CA 95815

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 Reassignment

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

Permanente Medical Group Inc

41 mi

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95815 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

$92.61 typical visit price

range $60.44 – $180.85

Typical copayment $23.15 (range $15.11 – $45.21)

Most-billed visit code 99203

Established Patient

$105.95 typical visit price

range $19.88 – $148.15

Typical copayment $26.48 (range $4.97 – $37.03)

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.

Other Providers at the Same Location NPPES 20

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

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