Individual provider Active NPI

Marisol Chirinos Tito, PA

  • Physician Assistant
  • Champaign, IL
National Provider Identifier
1255833695
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006525 Issued in IL
Practice address
1801 W Windsor Rd
Champaign, IL 61822-6217
Phone
(217) 366-8130
Fax
(217) 366-7488
NPI assigned
Mar 1, 2018
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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 085006525 IL Primary

Addresses

Primary practice location

1801 W Windsor Rd
Champaign, IL 61822-6217

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20180507001679 IL Practitioner - Physician Assistant 2466716030 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

508 Iaa Dr
Bloomington, IL 61701-2216
Phone (309) 451-2080

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085006525ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Nov 8, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Promise Healthcare NFP Current Accepting new patients
Promise Healthcare NFP CurrentSince Apr 10, 2018 Accepting new patients
Promise Healthcare NFP CurrentSince Apr 10, 2018 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

819 Bloomington Rd
Champaign, IL 61820
Phone (217) 356-1558

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: marisol.chirinos.p11@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1255833695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1200",
            "fax_number": "217-366-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WINDSOR RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226217",
            "telephone_number": "217-366-8130",
            "fax_number": "217-366-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRINOS TITO",
        "first_name": "MARISOL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-01",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.