AMANDA LY MD
NPI 1417410374
Physical Medicine & Rehabilitation in Santa Rosa, CA
About Amanda Ly Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA LY MD (NPI 1417410374) is an individual physical medicine & rehabilitation provider in Santa Rosa, California, licensed in California (A190157) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Rosa, and is a graduate of New York Medical College (2019).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
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
Amanda Ly Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Amanda Ly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Vallejo, CA 94589
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
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 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ROSA, CA 95403
SANTA ROSA, CA 95403
SANTA ROSA, CA 95403
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 Amanda Ly's NPI number?
The NPI number for Amanda Ly is 1417410374. It was assigned to this individual provider in the NPPES registry on April 8, 2019.
Where is Amanda Ly located?
Amanda Ly practices at 3975 Old Redwood Hwy Ste 152, Santa Rosa, CA 95403. The listed phone number is (707) 566-5555.
What is Amanda Ly's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.
Is Amanda Ly enrolled in Medicare?
Yes. Amanda 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 organization bills Medicare for Amanda Ly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Amanda 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 Amanda 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 Amanda Ly was last updated on October 8, 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.