Nicholas R Idle, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004157 Issued in IL

Practice address

611 W. Park St.
Hvi
Urbana, IL 61801-2500

Phone

(217) 904-7000

Fax

(217) 904-7742

NPI assigned

Oct 27, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • Mattoon, IL
  • NPI 1063030252

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • New Albany, IN
  • NPI 1477297083
  NPD (past)

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1467738005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "HVI",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-904-7000",
            "fax_number": "217-904-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDLE",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004157",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.004157",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ray Huston, D.O.
• Alana Marie Hutcheson, MD
• Crystal Ibeabuchi, PHARMD
• Tara Iddings, AU.D., CCC-A
• Etinosa Ann Idemudia, MD
• Iems Physician Services PLLC
• Raquel Tahud Igana, NP
• Ignite You Therapy PLLC
• Illini Smiles Dental Care P.C.
• Illini Smiles Dental Care P.C.

• Physician Assistant in Urbana, IL
• Providers in Urbana, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.