NPIMap

Individual provider Active NPI

Madeline Rose Dorn, PA-C

  • Physician Assistant
  • Saint Cloud, MN
National Provider Identifier
1043900475
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15275 Issued in MN
Practice address
1900 Centracare Cir Ste 2400
Saint Cloud, MN 56303-5000
Phone
(320) 229-4916
NPI assigned
May 9, 2023
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 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 15275 MN Primary

Addresses

Primary practice location

1900 Centracare Cir Ste 2400
Saint Cloud, MN 56303-5000

Mailing address

1900 Centracare Cir Ste 2400
Saint Cloud, MN 56303-5000
Phone (320) 229-4916

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmackinac865466@direct.centracare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305001771 MN Practitioner - Physician Assistant 8820519994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

110 2ND St S
Suite 104
Waite Park, MN 56387-1367
Phone (320) 259-9375

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

1900 Centracare Cir
Suite 2400
Saint Cloud, MN 56303-5000
Phone (320) 252-2422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Feb 7, 2025 Accepting new patients
St. Cloud Hospital CurrentSince Feb 7, 2025 Accepting new patients
St. Cloud Hospital CurrentSince Feb 7, 2025 Accepting new patients

Locations

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1900 Centracare Cir
Ste 2400
Saint Cloud, MN 56303
Phone (320) 229-4916

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Interoperability endpoints

  • Direct secure messaging: mmackinac865466@direct.centracare.com

Organizations & group practices 5

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1043900475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 2400",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 2400",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-229-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "MADELINE",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmackinac865466@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mmackinac865466@direct.centracare.com",
            "address_1": "1900 Centracare Cir Ste 2400",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563035000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.