Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Kevin Ly

Individual provider Family Medicine Physician · NPI 1720564289

Kevin Ly is registered under Family Practice in Bloomsburg, Pennsylvania. Qualified in 2018, 8 years ago. Practices with Geisinger Clinic, a 3,413-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2018
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Practice location Address checks out

240 Mall Blvd
Bloomsburg, PA 17815-8306
Phone: (570) 784-8303
Fax: (570) 387-5030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD475200 (PA)

Record details

NPI number1720564289
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 17, 2018
Last updated in NPPESSeptember 11, 2025
Certification dateSeptember 11, 2025

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Geisinger Clinic — 3413 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients264
Services billed 767 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Geisinger Clinic

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 3413 clinicians in the practice; 12 are shown here.

Other providers in Bloomsburg