NPIMap

Individual provider Active NPI

Bryan Colligan, DO

  • Internal Medicine Physician
  • Corry, PA
National Provider Identifier
1174905350
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS019484 Issued in PA
Practice address
965 Shamrock LN
Corry, PA 16407-9121
Phone
(814) 665-8288
Fax
(814) 664-8618
NPI assigned
Jun 23, 2015
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS019484 PA Primary

Addresses

Primary practice location

965 Shamrock LN
Corry, PA 16407-9121

Mailing address

2256 Lakeview Dr
Erie, PA 16506-6401

Other identifiers 1

IdentifierTypeStateIssuer
1035428460001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181004000029 PA Practitioner - Internal Medicine 8820305816 Reassigns benefits to 4 organizations
I20230227001096 NY Practitioner - Internal Medicine 8820305816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corry Memorial Hospital AssociationGroup PAC ID 3971581174, shared by 7 NPIs, 30 clinicians

Practice addresses (Care Compare)

354 Clymer Corry Rd
Clymer, NY 14724-9701
Phone (716) 355-2248

965 Shamrock LN
Corry, PA 16407-9121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Current Accepting new patients
Medical Associates of Erie CurrentSince Feb 1, 2020 Accepting new patients
Corry Memorial Hospital Association CurrentSince Jan 1, 2023 Accepting new patients
Medical Associates of Erie CurrentSince Feb 1, 2020 Accepting new patients
Medical Associates of Erie Internal Medicine Current Accepting new patients
Corry Memorial Hospital Association CurrentSince Nov 20, 2025 Accepting new patients
HCF of Corry, Inc. Past Accepting new patients
Corry Memorial Hospital Association Past Accepting new patients

Locations

354 Clymer Corry Rd
Clymer, NY 14724
Phone (716) 355-2248

300 York St
Corry, PA 16407
Phone (814) 664-3979

965 Shamrock Ln
Corry, PA 16407
Phone (814) 644-4641

1 Lecom Pl
Erie, PA 16505

2000 W Grandview Blvd
Erie, PA 16509
Phone (814) 868-1001

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

Interoperability endpoints

  • Direct secure messaging: bryan.colligan.1@10044.direct.athenahealth.com

Organizations & group practices 10

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

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1174905350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 LAKEVIEW DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 SHAMROCK LN",
            "city": "CORRY",
            "state": "PA",
            "postal_code": "164079121",
            "telephone_number": "814-665-8288",
            "fax_number": "814-664-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIGAN",
        "first_name": "BRYAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS019484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035428460001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corry, PA

Sources for this page

Verify at the official NPI Registry.