Individual provider Active NPI

Emma Shannon Carmody, PA

  • Physician Assistant
  • Bridgewater, NJ
National Provider Identifier
1932904414
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00914900 Issued in NJ
Practice address
41 Wexford Way
Bridgewater, NJ 08807-5592
Phone
(908) 507-2707
NPI assigned
Feb 18, 2025
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA66142 CA
Physician Assistant 363A00000X 25MP00914900 NJ Primary

Addresses

Primary practice location

41 Wexford Way
Bridgewater, NJ 08807-5592

Mailing address

41 Wexford Way
Bridgewater, NJ 08807-5592
Phone (908) 507-2707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250807002508 CA Practitioner - Physician Assistant 7315445525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enloe Specialty Physicians IncGroup PAC ID 7416111893, 24 clinicians

Practice addresses (Care Compare)

1531 Esplanade
Chico, CA 95926-3310
Phone (530) 332-7300

265 Cohasset Rd
Chico, CA 95926-2273
Phone (530) 332-3808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA66142CAMDPhysician Assistant
25MP00914900NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center Past Accepting new patients

Organizations & group practices 2

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 1

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": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1932904414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WEXFORD WAY",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075592",
            "telephone_number": "908-507-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WEXFORD WAY",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088075592",
            "telephone_number": "908-507-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMODY",
        "first_name": "EMMA",
        "middle_name": "SHANNON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66142",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00914900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.