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

Vincent Macino, PA

Individual provider Physician Assistant · NPI 1497291926

Vincent Macino, PA is a Physician Assistant in Mattoon, Illinois. Qualified in 2016, 10 years ago. Practices with Ivy Medical Group PLLC, a 121-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California, Florida, Illinois and Indiana and 11 more.

Years since qualifying
10
Licensed in
CA, FL, IL, IN, KS, MA
In the registry since
2017
Specialties on file
15
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

1201 Wooddell Way Ste B
Mattoon, IL 61938-1014
Phone: (217) 238-3000
Fax: (217) 238-3008
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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 085008400 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00899800 (NJ)
Physician Assistant Taxonomy 363A00000X · Licence TPPA811 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 0110010584 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 50.009240RX (OH)
Physician Assistant Taxonomy 363A00000X · Licence 54322 (CA)
Physician Assistant Taxonomy 363A00000X · Licence MA066292 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 033144 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 15-03032 (KS)
Physician Assistant Taxonomy 363A00000X · Licence 8220-23 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 6289 (TN)
Physician Assistant Taxonomy 363A00000X · Licence PA101183 (MA)
Physician Assistant Taxonomy 363A00000X · Licence 10005092A (IN)
Physician Assistant Taxonomy 363A00000X · Licence 2024049952 (MO)
Physician Assistant Taxonomy 363A00000X · Licence C0009755 (MD)

Record details

NPI number1497291926
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 8, 2017
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026
Mailing address9225 Henning Ln, Hennepin, IL 61327-5026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Ivy Medical Group Pllc — 121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations9 on file with Medicare

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