NPIMap

Individual provider Active NPI

Sarah J. Kincaid, PA-C

  • Physician Assistant
  • Urbana, IL
National Provider Identifier
1275789224
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003257 Issued in IL
Practice address
1111 W Kenyon Rd Ste B
Urbana, IL 61801-1006
Phone
(217) 819-3376
Fax
(217) 729-7788
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 085-003257 IL Primary

Addresses

Primary practice location

1111 W Kenyon Rd Ste B
Urbana, IL 61801-1006

Mailing address

1111 W Kenyon Rd Ste B
Urbana, IL 61801-1006
Phone (217) 819-3376

Other identifiers 2

IdentifierTypeStateIssuer
P00650145OtherILRAILROAD MEDICARE
279500OtherILMEDICARE GROUP

Other names 1

  • Sarah J Kistler Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skincaidpa288442@CarleHieDirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000862 IL Practitioner - Physician Assistant 4880754928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-2240

355 E Ash Ave
Decatur, IL 62526-6136
Phone (217) 450-9826

917 Remington Rd
Mattoon, IL 61938-4210
Phone (217) 205-3376

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-003257ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalskin Medical Group Il PLLC Physician Assistant CurrentSince Oct 1, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Vitalskin Medical Group Il PLLC Past Accepting new patients

Locations

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

917 Remington Rd
Mattoon, IL 61938
Phone (217) 205-3376

1111 W Kenyon Rd
Ste A
Urbana, IL 61801

1111 W Kenyon Rd
Urbana, IL 61801
Phone (217) 729-7650

1111 W Kenyon Rd
Ste B
Urbana, IL 61801
Phone (217) 729-7657

Interoperability endpoints

  • Direct secure messaging: skincaidpa288442@carlehiedirect.net

Organizations & group practices 3

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1275789224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W KENYON RD STE B",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011006",
            "telephone_number": "217-819-3376",
            "fax_number": "217-729-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W KENYON RD STE B",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011006",
            "telephone_number": "217-819-3376",
            "fax_number": "217-729-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "SARAH",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00650145",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "279500",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skincaidpa288442@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 W University Ave",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618203909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "KISTLER",
            "middle_name": "J",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.