Emma W Bollich, PA-C
Individual provider Active NPI Medical Physician Assistant · Broussard, LA
NPI 1972118776 · NPPES record last updated Sep 9, 2020
Key facts
- NPI
- 1972118776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 324303 (LA)
- Practice address
- 6703 Ambassador Caffery Pkwy Ste 2
Broussard, LA 70518-5283 - Phone
- (337) 948-1766
- Fax
- (337) 948-1768
- NPI assigned
- Sep 9, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Martin Physician Services LLC
Practice addresses (Care Compare)
210 Champagne Blvd
Breaux Bridge, LA 70517-3700
Phone (337) 332-2178
Hospital & facility affiliations
- Ochsner St Martin Hospital
- Ochsner Lafayette General Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201028000230 | LA | Practitioner - Physician Assistant | 0547670887 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospital & Clinics Inc | Current |
Accepting new patients | |
| Hulin Urgent Care Services LLC | Current |
Accepting new patients | |
| University Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Calcasieu Urgent Care, LLC | Current |
Accepting new patients | |
| Hulin Urgent Care Services LLC | Current |
Accepting new patients | |
| Calcasieu Urgent Care LLC | Current |
Accepting new patients |
Locations
2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000
2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919
1110 E Saint Peter St
New Iberia, LA 70560
Phone (337) 364-1166
Interoperability endpoints
- ebollich2018503@direct.ochsner.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 324303 | LA | Yes |
Addresses
Primary practice location
6703 Ambassador Caffery Pkwy Ste 2
Broussard, LA 70518-5283
Mailing address
123 Country Living Dr
Lafayette, LA 70507-2108
Phone (337) 501-5279
Other providers in Broussard, LA
- Terry Peterson Berniard
- John Austin Berry
- Karen Ann Bienvenu
- Ashton Paul Blanchard
- Natalie Breaux Blanchard
- Mercedes Sade' Boudreaux
- Therese Renee Boudreaux
- Blaine Phillip Boutte
- Breathing Centers of Acadiana, LLC
- Breedlove Medical, Inc
All providers in Broussard, LA · Medical Physician Assistant in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.