NICHOLAS R IDLE (PA) – Physician Assistant, NPI 1467738005

NICHOLAS R IDLE (PA) is a healthcare provider. based in Urbana, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 085004157 (IL). The NPI Number for NICHOLAS R IDLE (PA) is 1467738005

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS R IDLE (PA)
NPI
1467738005
Phone
(217) 904-7000
Address
611 W. PARK ST.
Enumeration Date
27 October 2011
Last Update Date
3 February 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172053376
Graduation Year
2011 (15 years ago)
PAC ID
2567623382
Group Practice PAC ID
5991116261
Professional Enrollment ID
I20120420000653
Address ID
IL619384210MA917XXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:14State licenses:2Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for NICHOLAS R IDLE (PA)

  • 611 W. PARK ST.

    HVI

    URBANA, IL 618012500

    Phone: (217) 904-7000

    Fax: (217) 904-7742

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 40 Open Payments records for all available years, with a total value of $1,300.

Total Amount is formed as General ($1,300) + Research ($0) + Ownership ($0) = $1,300.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Philips Electronics North America Corporation ($296).

Total Amount

$1,300

General + Research + Ownership

Payments

40

Total payment records

General Amount

$1,300

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-04-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120420000653IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
49083Drainage of fluid from abdominal cavity using imaging guidance24562$0
32555Aspiration of fluid from chest cavity using imaging guidance163107$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes8765$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes5857$0
10005Fine needle aspiration biopsy using ultrasound guidance, first growth4239$0
View full utilization report →

Insurance plans in this area (ZIP 61801)

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Provider's Procedures

NICHOLAS R IDLE (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTIL76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle2424

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991116261View full group profile
NameSpecialtyState
D E R M A T O L O G YIL
D E R M A T O L O G YNC
Nurse PractitionerIL
Nurse PractitionerKY
Physician AssistantIN
Nurse PractitionerKY
D E R M A T O L O G YMI
D E R M A T O L O G YIL
Physician AssistantIL
D E R M A T O L O G YPA

Reviews

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Frequently asked questions

Is NICHOLAS R IDLE (PA) listed with a National Provider Identifier?
Yes — NICHOLAS R IDLE (PA) has NPI 1467738005 on file in the registry.
Active or inactive — what applies to NICHOLAS R IDLE (PA)?
You should see NICHOLAS R IDLE (PA) as active in CMS-hosted NPPES data.
What area of care is associated with NICHOLAS R IDLE (PA)?
NICHOLAS R IDLE (PA)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for NICHOLAS R IDLE (PA)?
Travel planning: use Urbana, Illinois as the reference point for NICHOLAS R IDLE (PA), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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