Linda Ly, is a medicare enrolled "Psychologist" provider in San Diego, California. Her current practice location is
5230 Carroll Canyon Rd, San Diego, California. You can reach out to her office (for appointments etc.) via phone at
(970) 682-4572.
Linda Ly is licensed to practice in California (license number 35250) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1093188302.
Healthcare Provider's Profile
| Full Name | Linda Ly |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 5230 Carroll Canyon Rd, San Diego, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1093188302
- Provider Enumeration Date: 11/09/2015
- Last Update Date: 08/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 0941736524
- Enrollment ID: I20241205002812
Medical Identifiers
Medical identifiers for Linda Ly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093188302 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 35250 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Linda Ly allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Psychology Centers Apc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386066363
PECOS PAC ID: 6406170653
Enrollment ID: O20150119000828 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Linda Ly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Linda Ly,
5230 Carroll Canyon Rd,
San Diego, CA 92121-1778
Ph: (970) 682-4572 | Linda Ly,
5230 Carroll Canyon Rd,
San Diego, CA 92121-1778
Ph: (970) 682-4572 |
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