Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicholas R Idle, PA

Individual provider Physician Assistant · NPI 1467738005

Nicholas R Idle, PA is a Physician Assistant in Urbana, Illinois. Qualified in 2011, 15 years ago. Practices with Vitalskin Medical Group Il PLLC, a 56-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
15
Licensed in
IL
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

611 W Park St Hvi
Urbana, IL 61801-2500
Phone: (217) 904-7000
Fax: (217) 904-7742
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085004157 (IL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 085.004157 (IL)

Record details

NPI number1467738005
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 27, 2011
Last updated in NPPESFebruary 3, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Vitalskin Medical Group Il Pllc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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