Benjamin Ly, DO
NPI 1639963069 · Student in an Organized Health Care Education/Training Program · Grand Rapids, MI
Enrolled with Medicare as Order and Referring Only - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Benjamin Ly, DO is a Student in an Organized Health Care Education/Training Program provider in Grand Rapids, MI (NPI 1639963069).
Provider details
- NPI number
- 1639963069
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-04-09
- Last updated
- 2025-04-09
- Certified
- 2025-04-09
Frequently asked questions
- What is Benjamin Ly's NPI number?
- Benjamin Ly's National Provider Identifier (NPI) is 1639963069, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Benjamin Ly's specialty?
- Benjamin Ly is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Benjamin Ly located?
- Benjamin Ly's practice location on file with NPPES is 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502.
- What is Benjamin Ly's phone number?
- The practice phone number listed in the NPPES registry for Benjamin Ly is (616) 685-5000.
- Does Benjamin Ly accept Medicare?
- Benjamin Ly is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Benjamin Ly's NPI active?
- Yes — Benjamin Ly's NPI (1639963069) is active in the NPPES registry as of the last update on 2025-04-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.