Individual provider Active NPI

Megan Danielle Sampson Boone, PA

  • Physician Assistant
  • Anderson, IN
National Provider Identifier
1487320057
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003403A Issued in IN
Practice address
1515 N Madison Ave
Anderson, IN 46011-3453
Phone
(765) 298-4242
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 10003403A IN Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

1515 N Madison Ave
Anderson, IN 46011-3453

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7547

Other practice location 1

3500 S LaFountain St
Kokomo, IN 46902-3803
Phone (765) 453-0702

Other identifiers 1

IdentifierTypeStateIssuer
300057780MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20211229001777 IN Practitioner - Physician Assistant 6709277759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

1500 N Ritter Ave
Indianapolis, IN 46219-3027

1515 N Madison Ave
Anderson, IN 46011-3453

3500 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8571

3504 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 453-8600

3506 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 865-6700

3508 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 776-5704

3510 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 864-8765

3512 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 865-6633

3548 S Lafountain St
Kokomo, IN 46902-3803
Phone (765) 773-8403

7120 Clearvista Dr
Suite 4000
Indianapolis, IN 46256-1774
Phone (317) 621-7444

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262

8075 N Shadeland Ave
Indianapolis, IN 46250-2693

Hospital & facility affiliations

  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Jan 1, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1515 N Madison Ave
Anderson, IN 46011
Phone (317) 870-0488

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

Interoperability endpoints

  • Direct secure messaging: mboone501669@ecommunitydirect.com

Organizations & group practices 1

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 3

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1487320057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N MADISON AVE",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113453",
            "telephone_number": "765-298-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 S LaFountain St",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023803",
            "country_code": "US",
            "telephone_number": "765-453-0702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONE",
        "first_name": "MEGAN",
        "middle_name": "DANIELLE SAMPSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003403A",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300057780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.