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DAVID C LY PA-C
NPI 1982954913
Physician Assistant - Medical in Bridgeport, CT

Active since September 18, 2012PECOS EnrolledAccepts Medicare Assignment
267 GRANT ST, BRIDGEPORT, CT 06610(203) 284-3000 Get Directions Write a Review

NPPES record last updated: June 16, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 16, 2021, Dec 16, 2020, Aug 29, 2019 (3 updates tracked since 2019).

About David C Ly Pa-c NPPES

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

DAVID C LY PA-C (NPI 1982954913) is an individual medical provider in Bridgeport, Connecticut, licensed in Connecticut (2793) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1982954913
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDAVID C LYCredential: PA-C
Location Address267 GRANT STBridgeport, CT 06610
Mailing Address16 Allen PlNew Haven, CT 06512-1805 · (714) 623-5917
Phone(203) 284-3000
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 18, 2012
Last NPPES UpdateJune 16, 20213 updates tracked since enumeration
NPPES CertifiedJune 16, 2021
✔ NPI 1982954913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CT · 2793
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA61060288 (WA), 020734 (NY)
267 GRANT ST, Bridgeport, CT 06610
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1Elm and Carlton StreetsBuffalo, NY 14263-0001 · Phone (716) 845-2300
Location 2888 Swift BlvdRichland, WA 99352-3514 · Phone (509) 942-2648 · Fax (509) 942-2812

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David C Ly Pa-c 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.

PECOS PAC ID2769628437
PECOS Enrollment IDI20210610001253
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
29 services26 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients

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.

MR. ALEX SCOTT CADAN PA-C
Physician Assistant (Surgical)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4500
RYAN KEENAN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DR. BLAZE KELLY DO
Anesthesiology (Pain Medicine)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
KARINA K. LINCER
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
DOROTHY D. DAPONTE
Physical Therapy Assistant
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
MISS SANDRA SHIPKOWITZ APRN
Nurse Practitioner (Pediatrics)
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-4490
HOLLY S. ASHBY
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3000
TESSA GURALNICK DPT
Physical Therapist
267 GRANT ST
BRIDGEPORT, CT 06610
Greater Bridgeport Planning Region (203) 384-3708

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 David Ly's NPI number?

The NPI number for David Ly is 1982954913. It was assigned to this individual provider in the NPPES registry on September 18, 2012.

Where is David Ly located?

David Ly practices at 267 Grant St, Bridgeport, CT 06610. The listed phone number is (203) 284-3000.

What is David Ly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is David Ly enrolled in Medicare?

Yes. David 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.

When was this NPI record last updated?

The NPPES record for David Ly was last updated on June 16, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.