ELLEN LY (NP) – Nurse Practitioner, NPI 1215539820

ELLEN LY (NP) is a healthcare provider. based in Pasadena, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 2020115166 (CA). The NPI Number for ELLEN LY (NP) is 1215539820

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
ELLEN LY (NP)
NPI
1215539820
Phone
(626) 793-2885
Address
3452 E FOOTHILL BLVD STE 130
Enumeration Date
10 November 2020
Last Update Date
5 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6262540074
Graduation Year
2020 (6 years ago)
PAC ID
3274071485
Group Practice PAC ID
8527049261
Professional Enrollment ID
I20240820000906
Address ID
CA910073495AR289XXDRXX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for ELLEN LY (NP)

  • 3452 E FOOTHILL BLVD STE 130

    PASADENA, CA 911076006

    Phone: (626) 793-2885

    Fax: (626) 793-6262

    Type: Mailing

  • 289 W HUNTINGTON DR STE 401

    ARCADIA, CA 910073493

    Phone: (626) 254-0074

    Fax: (626) 254-0240

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 105 Open Payments records for all available years, with a total value of $2,000.

Total Amount is formed as General ($2,000) + Research ($0) + Ownership ($0) = $2,000.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($526).

Total Amount

$2,000

General + Research + Ownership

Payments

105

Total payment records

General Amount

$2,000

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240820000906INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91107)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527049261View full group profile
NameSpecialtyState
Nurse PractitionerCA
Physician AssistantCA
Nurse PractitionerCA
Cardiovascular Disease (Cardiology)CA
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)CA
Nurse PractitionerCA
Interventional Cardiology, Cardiovascular Disease (Cardiology), Peripheral Vascular DiseaseCA
-CA
Cardiovascular Disease (Cardiology), Internal MedicineCA
Advanced Heart Failure And Transplant CardiologyCA

Reviews

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Frequently asked questions

What NPI should I save for ELLEN LY (NP)?
Save NPI 1215539820 if you need a stable reference for ELLEN LY (NP).
Is ELLEN LY (NP) active in the national directory?
ELLEN LY (NP)'s public NPI profile is in an active state.
What does ELLEN LY (NP) treat or focus on?
Patients typically see ELLEN LY (NP) under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for ELLEN LY (NP)?
We surface Pasadena, California for ELLEN LY (NP) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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