NPIMap

Individual provider Active NPI

Madison Liedel McLachlan, DO

  • Sports Medicine (Family Medicine) Physician
  • Edina, MN
National Provider Identifier
1215565411
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
69720 Issued in MN
Practice address
8100 W 78TH St Ste 230
Edina, MN 55439-2570
Phone
(952) 946-9777
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 69720 MN Primary
Sports Medicine (Family Medicine) Physician 207QS0010X R-12973 IA
Family Medicine Physician 207Q00000X 69720 MN

Addresses

Primary practice location

8100 W 78TH St Ste 230
Edina, MN 55439-2570

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmclachlan673326@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN2 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
I20210903001852 MN Practitioner - Sports MedicinePractitioner - Family Practice 4183049331
I20240920002888 MN Practitioner - Family Practice 4183049331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

775 Prairie Ctr Dr
Suite 400
Eden Prairie, MN 55344-7322
Phone (612) 775-6200

8100 W 78TH St
Suite 100
Edina, MN 55439-2529
Phone (952) 914-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-12973IAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System Family Medicine Current Accepting new patients
Allina Health System CurrentSince Aug 26, 2024 Accepting new patients
Allina Health System CurrentSince Aug 26, 2024 Accepting new patients
Allina Health System CurrentSince Sep 30, 2024 Accepting new patients
Allina Health System Family Medicine Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

8100 W 78th St
Ste 230
Minneapolis, MN 55439
Phone (888) 892-7575

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

8100 W 78th St
Ste 100
Minneapolis, MN 55439
Phone (952) 914-8100

Interoperability endpoints

  • Direct secure messaging: mmclachlan673326@excellian.direct.allina.com

Organizations & group practices 6

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

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1215565411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 W 78TH ST STE 230",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392570",
            "telephone_number": "952-946-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLACHLAN",
        "first_name": "MADISON",
        "middle_name": "LIEDEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MN",
            "license": "69720",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IA",
            "license": "R-12973",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "69720",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmclachlan673326@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8100 W 78th St Ste 230",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554392570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.