Rincy Panicker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.005269 Issued in IL

Practice address

139 Golfview Dr
Glendale Heights, IL 60139-3675

Phone

(224) 381-1984

NPI assigned

Oct 6, 2014

Reactivated

Oct 30, 2024

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, LA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpanicker278269@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  LA

  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Trincare Inc

  dba TrinCare Clinical Laboratories

  • Clinical Medical Laboratory
  • Tyler, TX
  • NPI 1033351226
  NPD

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1720481682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 GOLFVIEW DR",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393675",
            "telephone_number": "224-381-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 GOLFVIEW DR",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601393675",
            "telephone_number": "224-381-1984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 North St Ste 420",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777021434",
            "country_code": "US",
            "telephone_number": "409-835-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 Wonder World Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786667558",
            "country_code": "US",
            "telephone_number": "512-396-3911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4046 Dowlen Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777066849",
            "country_code": "US",
            "telephone_number": "409-225-5924",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11823 Culebra Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782534563",
            "country_code": "US",
            "telephone_number": "210-598-1517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5638 Saratoga Blvd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784144134",
            "country_code": "US",
            "telephone_number": "361-444-5280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7045 Youree Dr",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711055108",
            "country_code": "US",
            "telephone_number": "318-798-3763",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1339 S Broadway St",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754824895",
            "country_code": "US",
            "telephone_number": "903-951-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9220 Ellerbe Rd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711066709",
            "country_code": "US",
            "telephone_number": "318-681-5282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANICKER",
        "first_name": "RINCY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2024-10-30",
        "certification_date": "2023-01-19",
        "deactivation_date": "2024-10-16",
        "reactivation_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14525",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "330590",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Glendale Heights, IL
• Providers in Glendale Heights, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.