JACK TIAHNYBIK DO
NPI 1114506433
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Q: What is Jack Tiahnybik's NPI number?

The NPI number for Jack Tiahnybik is 1114506433. It was assigned to this individual provider in the NPPES registry on April 5, 2021.

Q: What is Jack Tiahnybik's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Tiahnybik was last updated on April 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 05, 2021PECOS Enrolled

1120 W MICHIGAN ST # CL642, INDIANAPOLIS, IN 46202(317) 278-2686 Get Directions Write a Review

NPPES record last updated: April 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Jack Tiahnybik Do NPPES

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

JACK TIAHNYBIK DO (NPI 1114506433) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1114506433

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACK TIAHNYBIKCredential: DO

Location Address1120 W MICHIGAN ST # CL642Indianapolis, IN 46202-5209

Mailing Address1120 W Michigan St # Cl642Indianapolis, IN 46202-5209

Phone(317) 278-2686

Sole ProprietorYes

Enumeration DateApril 5, 2021

NPPES CertifiedApril 5, 2021

✔ NPI 1114506433 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1120 W MICHIGAN ST # CL642, Indianapolis, IN 46202

Open in Google Maps ↗

Secondary Practice Location 1

Location 1550 University BlvdIndianapolis, IN 46202-5149 · Phone (131) 794-4500

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Tiahnybik Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

DR. DESTINY J HAUSE MD

Student in an Organized Health Care Education/Training Program