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PRINCETON LY
NPI 1497118129
Pediatrics in Santa Monica, CA

Active since March 31, 2016PECOS Enrolled
2825 SANTA MONICA BLVD STE 104, SANTA MONICA, CA 90404(310) 829-9935(310) 829-1077 Get Directions Write a Review

NPPES record last updated: September 17, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 17, 2019, Mar 31, 2016 (2 updates tracked since 2016).

About Princeton Ly NPPES

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

PRINCETON LY (NPI 1497118129) is an individual pediatrics provider in Santa Monica, California, licensed in California (A156336) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497118129
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NamePRINCETON LY
Location Address2825 SANTA MONICA BLVD STE 104Santa Monica, CA 90404-2429
Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631
Phone(310) 829-9935
Fax(310) 829-1077
Sole ProprietorNo
Enumeration DateMarch 31, 2016
Last NPPES UpdateSeptember 17, 20192 updates tracked since enumeration
✔ NPI 1497118129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A156336
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.
2825 SANTA MONICA BLVD STE 104, Santa Monica, CA 90404
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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)

Princeton Ly 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 Reassignments

2

Medicare enrollment records show Princeton Ly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uc Regents
2.6 mi
Pediatrics
200 UCLA MEDICAL PLAZA, SUITE 265
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 323 clinicians in this Medicare group
NPI 1982667663 (310) 825-0867
The Regents Of The University Of California
3.0 mi
Internal Medicine
200 MEDICAL PLAZA, SUITE 365,530,420,250,120,214
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 1,766 clinicians in this Medicare group
NPI 1235107566 (310) 794-1276

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 90404 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
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.

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.

JAYME E. HEATH M.D.
Pediatrics
2825 SANTA MONICA BLVD STE 104
SANTA MONICA, CA 90404
Los Angeles County (310) 829-9935
WENDY YUWENG SUN MD
Pediatrics
2825 SANTA MONICA BLVD STE 104
SANTA MONICA, CA 90404
Los Angeles County (310) 829-9935

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 Princeton Ly's NPI number?

The NPI number for Princeton Ly is 1497118129. It was assigned to this individual provider in the NPPES registry on March 31, 2016.

Where is Princeton Ly located?

Princeton Ly practices at 2825 Santa Monica Blvd Ste 104, Santa Monica, CA 90404. The listed phone number is (310) 829-9935.

What is Princeton Ly's specialty?

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

Is Princeton Ly enrolled in Medicare?

Yes. Princeton Ly is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Princeton Ly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Princeton Ly reassigns Medicare benefits to 2 organizations: Uc Regents (Los Angeles, CA) and The Regents Of The University Of California (Los Angeles, 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 Princeton 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 Princeton Ly was last updated on September 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.