Individual provider Active NPI

Collin Haugh

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1790366862
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003413A Issued in IN
Practice address
7979 N Shadeland Ave Ste 310
Indianapolis, IN 46250-2042
Phone
(317) 621-3092
Fax
(317) 621-3088
NPI assigned
Apr 19, 2021
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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 10003413A IN Primary

Addresses

Primary practice location

7979 N Shadeland Ave Ste 310
Indianapolis, IN 46250-2042

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

333 Murfreesboro Pike
Nashville, TN 37210-2834
Phone (615) 248-1200

Other practice location 2

7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 355-5041

Other identifiers 1

IdentifierTypeStateIssuer
300055388MedicaidIN

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
I20211011001818 IN Practitioner - Physician Assistant 4284032970 Reassigns benefits to 3 organizations

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
Community Physician Network Specialty Care LLCGroup PAC ID 9931697265, 260 clinicians

Practice addresses (Care Compare)

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

7979 N Shadeland Ave
Indianapolis, IN 46250-2042

8075 N Shadeland Ave
Indianapolis, IN 46250-2693
Phone (317) 621-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
95.35
Improvement activities
40
Cost
78.59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 29, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 29, 2025 Accepting new patients
Trevecca Nazarene University PastSince Apr 1, 2021 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

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

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

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

7979 N Shadeland Ave
Ste 310
Indianapolis, IN 46250
Phone (317) 621-3780

8075 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-8000

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 4

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": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1790366862",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 N SHADELAND AVE STE 310",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502042",
            "telephone_number": "317-621-3092",
            "fax_number": "317-621-3088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Murfreesboro Pike",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372102834",
            "country_code": "US",
            "telephone_number": "615-248-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7150 Clearvista Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561695",
            "country_code": "US",
            "telephone_number": "317-355-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGH",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003413A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300055388",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.