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MADISON OTT MD
NPI 1003496571
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Active since April 09, 2021PECOS Enrolled
1120 W MICHIGAN ST # CL630, INDIANAPOLIS, IN 46202(317) 278-2686 Get Directions Write a Review

NPPES record last updated: June 8, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 8, 2022, Jul 28, 2021, Apr 9, 2021 (3 updates tracked since 2021).

About Madison Ott Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MADISON OTT MD (NPI 1003496571) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Lawrenceville.

NPPES Registry Identity

NPI1003496571
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMADISON OTTCredential: MD
Location Address1120 W MICHIGAN ST # CL630Indianapolis, IN 46202-5209
Mailing Address355 W 16th StIndianapolis, IN 46202-2207 · (317) 963-7533 · Fax (317) 963-7533
Phone(317) 278-2686
Sole ProprietorYes
Enumeration DateApril 9, 2021
Last NPPES UpdateJune 8, 20223 updates tracked since enumeration
NPPES CertifiedApril 8, 2022
✔ NPI 1003496571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License LL86159 (SC)
1120 W MICHIGAN ST # CL630, Indianapolis, IN 46202
Open in Google Maps ↗

Secondary Practice Location 1

Location 11000 Medical Center BlvdLawrenceville, GA 30046-7694 · Phone (678) 312-3294 · Fax (678) 312-3282

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Madison Ott Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Madison Ott reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northside Primary Care Professional Services, LLC
391 mi
Urgent Care
81 NORTHSIDE DAWSON DRIVE
Dawsonville, GA 30534
  • Reassigned Medicare billing, Georgia enrollment
  • 466 clinicians in this Medicare group
NPI 1215369715 (855) 709-4535

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL SAM ROSENHECK
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
AARON CRAIG MINER MD
Anesthesiology
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
DR. JEFFREY FREIDENSON MD
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2659
SAIISHITHA NALAMOLU DO
Student in an Organized Health Care Education/Training Program
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
MOHSIN MUKHTAR MD
Radiology (Diagnostic Radiology)
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2689
ERIC CHUNG MD
Anesthesiology
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2689
RUSSELL DYLAN PURPURA MD
Internal Medicine (Pulmonary Disease)
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2686
CODY MITCHEL JINNETTE DO
Internal Medicine (Infectious Disease)
1120 W MICHIGAN ST # CL630
INDIANAPOLIS, IN 46202
Marion County (317) 278-2689

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Madison Ott's NPI number?

The NPI number for Madison Ott is 1003496571. It was assigned to this individual provider in the NPPES registry on April 9, 2021.

Where is Madison Ott located?

Madison Ott practices at 1120 W Michigan St # Cl630, Indianapolis, IN 46202. The listed phone number is (317) 278-2686.

What is Madison Ott's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Madison Ott enrolled in Medicare?

Yes. Madison Ott is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Madison Ott's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madison Ott reassigns Medicare benefits to Northside Primary Care Professional Services, LLC (Dawsonville, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Madison Ott's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Madison Ott accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Madison Ott as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Madison Ott was last updated on June 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.