NICHOLAS RAY VON HOLTEN PA-C NPI 1063054278

NPI Information

  • NPI: 1063054278
  • Provider Name: NICHOLAS RAY VON HOLTEN, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1111 TRINITY LN STE 111
    BLOOMINGTON, IL
    ZIP 61704
  • Phone: (309) 663-6461

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NPI Details

Nicholas Ray Von Holten, PA-C is a physician assistant in Bloomington, IL with 6 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Nicholas Ray Von Holten, PA-C NPI is 1063054278. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1111 TRINITY LN STE 111
BLOOMINGTON, IL
ZIP 61704-112
Phone: (309) 663-6461

The NPI 1063054278 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg (HCPCS:J7328)
  • Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg (HCPCS:J7318)
  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Injection, ropivacaine hydrochloride, 1 mg (HCPCS:J2795)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Replacement of knee joint, both sides of knee (HCPCS:27447)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • X-ray of knee, 3 views (HCPCS:73562)

The enumeration date for this NPI number is 10/9/2019 and was last updated on 10/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical085.007292ILLINOISNo
2363A00000XPhysician Assistant085.007292ILLINOISYes
3363AM0700XPhysician AssistantMedical085.007292ILLINOISNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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