Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amanda Ly, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1417410374

Amanda Ly, MD is a Physical Medicine and Rehabilitation in Santa Rosa, California. Graduated from New York Medical College in 2019, 7 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
7
Trained at
New York Medical College
Licensed in
CA
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3975 Old Redwood Hwy Ste 152
Santa Rosa, CA 95403-1719
Phone: (707) 566-5555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3975 Old Redwood Hwy Ste 152, Santa Rosa, CA 95403-1719 — (707) 566-5555

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence A190157 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1417410374
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 8, 2019
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2019 (7 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Santa Rosa