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ANTONIA J GENISIO LCPC
NPI 1245961606
Counselor - Professional in Jacksonville, IL

Active since June 17, 2022PECOS EnrolledAccepts Medicare Assignment
15 FOUNDERS LN STE 100, JACKSONVILLE, IL 62650(217) 243-0300(217) 245-6775 Get Directions Write a Review

NPPES record last updated: December 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 20, 2024, Nov 22, 2024, Apr 26, 2024 and 1 more (4 updates tracked since 2022).

About Antonia J Genisio Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTONIA J GENISIO LCPC (NPI 1245961606) is an individual professional provider in Jacksonville, Illinois, licensed in Illinois (180016629) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1245961606
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameANTONIA J GENISIOCredential: LCPC
Location Address15 FOUNDERS LN STE 100Jacksonville, IL 62650-3924
Mailing Address15 Founders Ln Ste 100Jacksonville, IL 62650-3924 · (217) 243-0300 · Fax (217) 245-6775
Phone(217) 243-0300
Fax(217) 245-6775
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 17, 2022
Last NPPES UpdateDecember 20, 20244 updates tracked since enumeration
NPPES CertifiedDecember 20, 2024
✔ NPI 1245961606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180016629
15 FOUNDERS LN STE 100, Jacksonville, IL 62650
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Antonia J Genisio Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618404930
PECOS Enrollment IDI20241227002384
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Antonia Genisio reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Memorial Physician Services
29 mi
Family Medicine
3132 OLD JACKSONVILLE RD
Springfield, IL 62704
  • Reassigned Medicare billing, Illinois enrollment
  • 150 clinicians in this Medicare group
NPI 1174877930 (217) 862-0800
Mental Health Centers Of Central Illinois
32 mi
Clinical
901 N 1ST ST, SUITE 225
Springfield, IL 62702
  • Reassigned Medicare billing, Illinois enrollment
  • 23 clinicians in this Medicare group
NPI 1750614798 (217) 788-4065

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DENISE L SKINNER LCPC
Counselor (Professional)
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
DANICA B MCKAIN APN
Nurse Practitioner (Pediatrics)
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
DR. EDWIN ROY MATHEWS DO
Internal Medicine
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
DR. MICHELLE COLEN M.D.
Family Medicine
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
DRAKE GASHKOFF M.D.
Family Medicine
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
MARLEE N HAGER
Nurse Practitioner (Family)
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
ANTHONY M GRIFFIN MD
Internal Medicine
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300
DAVID DYLAN PATE PA-C
Physician Assistant (Medical)
15 FOUNDERS LN STE 100
JACKSONVILLE, IL 62650
Morgan County (217) 243-0300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Antonia Genisio's NPI number?

The NPI number for Antonia Genisio is 1245961606. It was assigned to this individual provider in the NPPES registry on June 17, 2022.

Where is Antonia Genisio located?

Antonia Genisio practices at 15 Founders Ln Ste 100, Jacksonville, IL 62650. The listed phone number is (217) 243-0300.

What is Antonia Genisio's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Antonia Genisio enrolled in Medicare?

Yes. Antonia Genisio is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Antonia Genisio's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Antonia Genisio reassigns Medicare benefits to 2 organizations: Memorial Physician Services (Springfield, IL) and Mental Health Centers Of Central Illinois (Springfield, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Antonia Genisio's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Antonia Genisio was last updated on December 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.