DR. ETHAN THOMAS PAULIN M.D.
NPI 1194172106
Student in an Organized Health Care Education/Training Program in Valhalla, NY

Q: What is Ethan Paulin's NPI number?

The NPI number for Ethan Paulin is 1194172106. It was assigned to this individual provider in the NPPES registry on May 19, 2016.

Q: What is Ethan Paulin'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 Ethan Paulin was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 19, 2016PECOS Enrolled

100 WOODS RD, VALHALLA, NY 10595(914) 493-1223 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Oct 31, 2023, May 19, 2016 (2 updates tracked since 2016).

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About Dr. Ethan Thomas Paulin M.d. NPPES

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

DR. ETHAN THOMAS PAULIN M.D. (NPI 1194172106) is an individual student in an organized health care education/training program in Valhalla, New York and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Port Jefferson Station.

NPPES Registry Identity

NPI1194172106

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. ETHAN THOMAS PAULINCredential: M.D.

Location Address100 WOODS RDValhalla, NY 10595-1530

Mailing Address101 Legend Dr Apt 3315Sleepy Hollow, NY 10591-3495 · (484) 716-8255

Phone(914) 493-1223

Sole ProprietorYes

Enumeration DateMay 19, 2016

Last NPPES UpdateJune 10, 20262 updates tracked since enumeration

NPPES CertifiedJune 10, 2026

✔ NPI 1194172106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedPlastic SurgeryTaxonomy 208200000X · License 322840 (NY)

100 WOODS RD, Valhalla, NY 10595

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Secondary Practice Location 1

Location 196 Terryville RdPort Jefferson Station, NY 11776-1388 · Phone (631) 815-2366

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan Thomas Paulin M.d. 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.

MRS. LISA ANN SAUER N.P.

Nurse Practitioner (Neonatal, Critical Care)