DR. COLLEEN MARY BANNIGAN (DO) – Emergency Medicine Physician, NPI 1306412747

DR. COLLEEN MARY BANNIGAN (DO) is a healthcare provider. based in Springfield, Massachusetts. specializing in SPORTS MEDICINE. They hold the professional credentials DO. They hold a License No. 0102208499 (VA). The NPI Number for DR. COLLEEN MARY BANNIGAN (DO) is 1306412747

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. COLLEEN MARY BANNIGAN (DO)
NPI
1306412747
Phone
(413) 794-0000
Address
759 CHESTNUT ST
Enumeration Date
27 May 2021
Last Update Date
15 July 2025

Doctor Profile

Medical School Name
EDWARD VIA COL OF OSTEO MEDICINE-VIRGINIA CAMPUS
Secondary Phone
5409511111
Graduation Year
2021 (5 years ago)
PAC ID
9234531559
Group Practice PAC ID
4789932385
Professional Enrollment ID
I20250729001527
Address ID
VA240607017BL3700XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

164 SPORTS MEDICINE in MA

Provider Addresses for DR. COLLEEN MARY BANNIGAN (DO)

  • 759 CHESTNUT ST

    SPRINGFIELD, MA 011990001

    Phone: (413) 794-0000

    Type: Mailing

  • 1691 INNOVATION DR STE 2100

    BLACKSBURG, VA 240606618

    Phone: (540) 232-8405

    Fax: (550) 232-8429

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250729001527ISports MedicineVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01199)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789932385View full group profile
NameSpecialtyState
Nurse PractitionerVA
Emergency MedicineNY
Nurse PractitionerVA
Nurse PractitionerLA
Emergency MedicineSC
Emergency MedicineVA
Emergency MedicineVA
Emergency MedicineVA
Emergency MedicineTX
Emergency MedicineNC

Reviews

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Frequently asked questions

Can I verify DR. COLLEEN MARY BANNIGAN (DO) with an NPI only?
You can start verification with NPI 1306412747 for DR. COLLEEN MARY BANNIGAN (DO), then check state licensing separately.
Can I rely on DR. COLLEEN MARY BANNIGAN (DO) being an active provider?
As of the registry snapshot, DR. COLLEEN MARY BANNIGAN (DO) is marked active.
What healthcare role does DR. COLLEEN MARY BANNIGAN (DO) hold?
Scheduling teams often label DR. COLLEEN MARY BANNIGAN (DO) under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does DR. COLLEEN MARY BANNIGAN (DO) serve?
DR. COLLEEN MARY BANNIGAN (DO)'s listing highlights Springfield, Massachusetts; more addresses can appear in NPPES.
Why does DR. COLLEEN MARY BANNIGAN (DO) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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