Nicholas Ray Von Holten, PA-C - Medicare Physician Assistant in Bloomington, IL

Nicholas Ray Von Holten, PA-C is a medicare enrolled "Physician Assistant" in Bloomington, Illinois. He went to Indiana University School Of Medicine and graduated in 2019 and has 5 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Carle West Physician Group Inc and his current practice location is 1111 Trinity Ln Ste 111, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 663-6461.

Nicholas Ray Von Holten is licensed to practice in Illinois (license number 085.007292) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063054278.

Contact Information

Nicholas Ray Von Holten, PA-C
1111 Trinity Ln Ste 111,
Bloomington, IL 61704-8112
(309) 663-6461
Not Available

Map and Direction




Provider's Profile

Full NameNicholas Ray Von Holten
GenderMale
SpecialityPhysician Assistant
Experience5 Years
Location1111 Trinity Ln Ste 111, Bloomington, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nicholas Ray Von Holten attended and graduated from Indiana University School Of Medicine in 2019
  NPI Data:
  • NPI Number: 1063054278
  • Provider Enumeration Date: 10/09/2019
  • Last Update Date: 10/09/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 4587096607
  • Enrollment ID: I20191112000095

Medical Identifiers

Medical identifiers for Nicholas Ray Von Holten such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063054278NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AS0400XPhysician Assistant - Surgical 085.007292 (Illinois)Secondary
363A00000XPhysician Assistant 085.007292 (Illinois)Primary
363AM0700XPhysician Assistant - Medical 085.007292 (Illinois)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Advocate Bromenn Medical CenterNormal, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Carle West Physician Group Inc8921420308254

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas Ray Von Holten is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nicholas Ray Von Holten, PA-C
21 Prenzler Dr,
Bloomington, IL 61704-1299

Ph: (309) 824-6658
Nicholas Ray Von Holten, PA-C
1111 Trinity Ln Ste 111,
Bloomington, IL 61704-8112

Ph: (309) 663-6461

Reviews and Comments


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Practice Location: 1111 Trinity Ln Ste 111, Bloomington, IL 61704
Phone: 309-663-6461    Fax: 309-663-5711

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.