VAN THANH LY FNP-C
NPI 1790426781
Nurse Practitioner - Family in San Jose, CA

Q: What is Van Ly's NPI number?

The NPI number for Van Ly is 1790426781. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Q: What is Van Ly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Van Ly was last updated on September 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 April 05, 2022PECOS Enrolled

200 JOSE FIGUERES AVE STE 180, SAN JOSE, CA 95116(408) 876-0836 Get Directions Write a Review

NPPES record last updated: September 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 6, 2022, Apr 5, 2022 (2 updates tracked since 2022).

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About Van Thanh Ly Fnp-c NPPES

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

VAN THANH LY FNP-C (NPI 1790426781) is an individual family provider in San Jose, California, licensed in California (95020564) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1790426781

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameVAN THANH LYCredential: FNP-C

Location Address200 JOSE FIGUERES AVE STE 180San Jose, CA 95116-1586

Mailing Address8721 Church StGilroy, CA 95020-4233 · (408) 876-0836

Phone(408) 876-0836

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 5, 2022

Last NPPES UpdateSeptember 6, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 6, 2022

✔ NPI 1790426781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95020564

200 JOSE FIGUERES AVE STE 180, San Jose, CA 95116

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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)

Van Thanh Ly Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688196678

PECOS Enrollment IDI20260220001325

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 95116 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

$106.47 typical visit price

range $70.37 – $206.04

Typical copayment $26.61 (range $17.59 – $51.51)

Most-billed visit code 99203

Established Patient

$121.77 typical visit price

range $23.96 – $169.60

Typical copayment $30.44 (range $5.99 – $42.40)

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 5

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

BAY AREA HOSPITAL PHYSICIAN

Internal Medicine