Individual provider Active NPI

Emily Camille Colligan, PA

  • Physician Assistant
  • Opelousas, LA
National Provider Identifier
1043049174
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
035710 Issued in NY
Practice address
539 E Prudhomme St
Opelousas, LA 70570-6499
Phone
(337) 948-3011
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 035710 NY Primary

Addresses

Primary practice location

539 E Prudhomme St
Opelousas, LA 70570-6499

Mailing address

539 E Prudhomme St
Opelousas, LA 70570-6499

Other practice location 1

2025 Broadway
New York, NY 10023-5016
Phone (212) 390-8812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250307000184 LA Practitioner - Physician Assistant 6204357148 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1043049174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 E PRUDHOMME ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 E PRUDHOMME ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706499",
            "telephone_number": "337-948-3011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100235016",
            "country_code": "US",
            "telephone_number": "212-390-8812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLIGAN",
        "first_name": "EMILY",
        "middle_name": "CAMILLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "035710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelousas, LA

Sources for this page

Verify at the official NPI Registry.