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KATERINA LY PA-C
NPI 1629958749
Physician Assistant - Surgical in Dallas, TX

Active since September 08, 2025PECOS Enrolled
4925 GREENVILLE AVE, STE 1307, ENERGY SQUARE 1, DALLAS, TX 75206(214) 242-1389(214) 351-8451 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 9, 2025, Oct 9, 2025, Sep 8, 2025 (3 updates tracked since 2025).

About Katerina Ly Pa-c NPPES

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

KATERINA LY PA-C (NPI 1629958749) is an individual surgical provider in Dallas, Texas and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1629958749
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameKATERINA LYCredential: PA-C
Location Address4925 GREENVILLE AVE, STE 1307, ENERGY SQUARE 1Dallas, TX 75206
Mailing Address4925 Greenville Ave, Ste 1307, Energy Square 1Dallas, TX 75206 · (214) 242-1389 · Fax (214) 351-8451
Phone(214) 242-1389
Fax(214) 351-8451
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 8, 2025
Last NPPES UpdateDecember 9, 20253 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1629958749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
4925 GREENVILLE AVE, Dallas, TX 75206
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katerina Ly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7618454216
PECOS Enrollment IDI20260126001895
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.

Other Providers at the Same Location NPPES 10

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

MADELENE MARTIN
Nurse Practitioner (Family)
4925 GREENVILLE AVE
DALLAS, TX 75206
Dallas County (214) 242-1389
ASCENDANT NEUROSTIMULATION LLC
Specialist
4925 GREENVILLE AVE, #200
DALLAS, TX 75206
Dallas County (214) 261-3600
JOAN P. DOLAN MED LPC
Counselor (Professional)
4925 GREENVILLE AVE, SUITE #608
DALLAS, TX 75206
Dallas County (214) 243-8181
DR. DOUGLAS ABRAHAM SHEENA MD
Emergency Medicine
4925 GREENVILLE AVE, SUITE 200
DALLAS, TX 75206
Dallas County (214) 361-1946
ROBERT E. SLOCUM, D.O.,P.A.
General Practice
4925 GREENVILLE AVE, SUITE 1158
DALLAS, TX 75206
Dallas County (214) 691-1224
MRS. ROSALYNN HERNANDEZ PETRUTSAS LPC
Counselor (Mental Health)
4925 GREENVILLE AVE
DALLAS, TX 75206
Dallas County (214) 433-6433
MARGARET RONEY LPC
Counselor (Professional)
4925 GREENVILLE AVE, 608
DALLAS, TX 75206
Dallas County (469) 693-1947
PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC
Speech-Language Pathologist
4925 GREENVILLE AVE, SUITE 200
DALLAS, TX 75206
Dallas County (214) 988-5437

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 Katerina Ly's NPI number?

The NPI number for Katerina Ly is 1629958749. It was assigned to this individual provider in the NPPES registry on September 8, 2025.

Where is Katerina Ly located?

Katerina Ly practices at 4925 Greenville Ave Ste 1307, Energy Square 1, Dallas, TX 75206. The listed phone number is (214) 242-1389.

What is Katerina Ly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Katerina Ly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Katerina Ly was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.