ETHAN CHERNIVEC MD
NPI 1336897586
Student in an Organized Health Care Education/Training Program in Indianapolis, IN

Q: What is Ethan Chernivec's NPI number?

The NPI number for Ethan Chernivec is 1336897586. It was assigned to this individual provider in the NPPES registry on March 16, 2022.

Q: What is Ethan Chernivec'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 Chernivec was last updated on May 27, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 16, 2022PECOS Enrolled

545 BARNHILL DR # EH125, INDIANAPOLIS, IN 46202(317) 274-7436 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 27, 2025, Apr 4, 2023 (2 updates tracked since 2023).

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About Ethan Chernivec Md NPPES

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

ETHAN CHERNIVEC MD (NPI 1336897586) is an individual student in an organized health care education/training program in Indianapolis, Indiana and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1336897586

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameETHAN CHERNIVECCredential: MD

Location Address545 BARNHILL DR # EH125Indianapolis, IN 46202-5112

Mailing Address545 Barnhill Dr # Eh125Indianapolis, IN 46202-5112 · (317) 274-7436

Phone(317) 274-7436

Sole ProprietorNo

Enumeration DateMarch 16, 2022

Last NPPES UpdateMay 27, 20252 updates tracked since enumeration

NPPES CertifiedMay 27, 2025

✔ NPI 1336897586 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 ListedSurgeryTaxonomy 208600000X · License 01095904A (IN)

545 BARNHILL DR # EH125, Indianapolis, IN 46202

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Secondary Practice Location 1

Location 11701 N Senate BlvdIndianapolis, IN 46202-1239 · Phone (317) 944-5000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Chernivec Md 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.

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