Individual provider Active NPI

Madeline Grace Reagan

  • Physician Assistant
  • Columbus, IN
National Provider Identifier
1619760782
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004926A Issued in IN
Practice address
4035 Mimosa Dr
Columbus, IN 47201-7200
Phone
(831) 786-5904
Fax
(317) 867-5321
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004926A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4035 Mimosa Dr
Columbus, IN 47201-7200

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

5230 E Stop 11 Rd Ste 150A
Indianapolis, IN 46237-6399
Phone (317) 865-5904

Other names 1

  • Madeline Clements Former name

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
I20250820001043 IN Practitioner - Physician Assistant 9830698331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

150 W Washington St
Shelbyville, IN 46176-1236
Phone (317) 865-5904

1704 Lafayette Rd
Crawfordsville, IN 47933-1071

4035 Mimosa Dr
Columbus, IN 47201-7200
Phone (317) 893-1900

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Sep 7, 2025 Accepting new patients
Franciscan Physician Network CurrentSince Sep 7, 2025 Accepting new patients
Major Hospital Past Accepting new patients
Franciscan Physician Network Past Accepting new patients

Locations

4035 Mimosa Dr
Columbus, IN 47201
Phone (317) 706-2361

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

5230 E Stop 11 Rd
Ste 150
Indianapolis, IN 46237
Phone (317) 856-5904

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 4

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": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1619760782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MIMOSA DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472017200",
            "telephone_number": "831-786-5904",
            "fax_number": "317-867-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5230 E Stop 11 Rd Ste 150A",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462376399",
            "country_code": "US",
            "telephone_number": "317-865-5904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "MADELINE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004926A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELINE",
            "last_name": "CLEMENTS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.