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

Amanda Van Ly, DO

Individual provider Surgery Physician · NPI 1417443334

Amanda Van Ly, DO is a General Surgery in Roseville, California. Graduated from West Virginia School of Osteopathic Medicine in 2018, 8 years ago. Practices with Sierra Medical Partnership, an 18-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
8
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
MI
In the registry since
2018
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

584 N Sunrise Ave Ste 100
Roseville, CA 95661-2862
Phone: (916) 250-2596
Fax: (916) 550-5025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 5101024118 (MI)

Record details

NPI number1417443334
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 3, 2018
Last updated in NPPESJuly 21, 2023
Certification dateJuly 21, 2023
Mailing address1625 Creekside Dr Ste 202, Folsom, CA 95630-3819

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2018 (8 years in practice)
Group practice Sierra Medical Partnership — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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