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Physician Compare National (NPI:1831345214)

HEALTHCARE PROVIDER: NGOC XUAN LY M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1831345214
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4688843733
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20131220001087
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name LY
Individual professional last name
Provider First Name NGOC
Individual professional first name
Provider Middle Name X
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2006
Individual professional's medical school graduation year
Primary Specialty FAMILY MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 EMERGENCY MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties EMERGENCY MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name PROGRESSIVE URGENT CARE PC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7810286663
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 7306 MAPLE PL
Group Practice or individual's line 1 address
City ANNANDALE
Group Practice or individual's city
State VA
Group Practice or individual's state
Zip Code 220033005
Group Practice or individual's zip code (9 digits when available)
Phone Number 7033335001
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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