Individual provider Active NPI

Ethan Bailey, PA

  • Physician Assistant
  • Columbus, IN
National Provider Identifier
1679023345
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003274A Issued in IN
Practice address
4665 N US Highway 31
Columbus, IN 47201-8558
Phone
(812) 376-9353
Fax
(812) 376-3757
NPI assigned
Oct 6, 2016
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 10003274A IN Primary
Surgical Physician Assistant 363AS0400X 10003274A IN

Addresses

Primary practice location

4665 N US Highway 31
Columbus, IN 47201-8558

Mailing address

703 Trent Dr
Greenwood, IN 46143-7424

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
I20210702002678 IN Practitioner - Physician Assistant 8123420718 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
Southern Indiana Orthopedics IncGroup PAC ID 0941281836, 18 clinicians

Practice addresses (Care Compare)

4665 N US Hwy 31
Columbus, IN 47201-8558
Phone (812) 376-9353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003274AINMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Indiana Orthopedics Inc CurrentSince Oct 1, 2025 Accepting new patients
Major Hospital Past Accepting new patients

Locations

4665 N US Highway 31
Columbus, IN 47201
Phone (812) 343-2755

Organizations & group practices 2

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 1

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": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679023345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 TRENT DR",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 N US HIGHWAY 31",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472018558",
            "telephone_number": "812-376-9353",
            "fax_number": "812-376-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ETHAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-06",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003274A",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10003274A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.