John Kincinas, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085002155 Issued in IL

Practice address

2500 W Reynolds St
Pontiac, IL 61764-9774

Phone

(815) 844-4062

Fax

(815) 844-4962

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Bromenn Physicians Management Corporation

  • Family Medicine Physician
  • Normal, IL
  • NPI 1285903799
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1477572154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-844-4062",
            "fax_number": "815-844-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-844-4062",
            "fax_number": "815-844-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCINAS",
        "first_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5315769",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Kennedy
• Misty Kessinger, BS
• Kimberly K Kidner, D.C.
• Laurel Kietzman, MD
• Robert W Kinas, LCPC
• Kind Living Therapy, LLC
• Kianna R Klendworth, BS
• Matthew Charles Knapp, PT
• Tanya M Knauff, PT
• Kendel S Knudson, OTD, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.