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DR. ETHAN PAVLOVSKY DO
NPI 1407505233
General Practice in Plano, TX

Active since March 20, 2022PECOS Enrolled
3901 W 15TH ST, PLANO, TX 75075(972) 396-4075 Get Directions Write a Review

NPPES record last updated: March 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 8, 2026, May 16, 2022 (2 updates tracked since 2022).

About Dr. Ethan Pavlovsky Do NPPES

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

DR. ETHAN PAVLOVSKY DO (NPI 1407505233) is an individual general practice provider in Plano, Texas, licensed in Texas (W4177) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1407505233
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. ETHAN PAVLOVSKYCredential: DO
Location Address3901 W 15TH STPlano, TX 75075-7738
Mailing Address3901 W 15th StPlano, TX 75075-7738 · (972) 396-4075
Phone(972) 396-4075
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 20, 2022
Last NPPES UpdateMarch 8, 20262 updates tracked since enumeration
NPPES CertifiedMarch 8, 2026
✔ NPI 1407505233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in TX · W4177
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

3901 W 15TH ST, Plano, TX 75075
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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 Pavlovsky Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557803814
PECOS Enrollment IDI20260611004444
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. STEVEN ROBERT REIMAN MD
Radiology (Diagnostic Radiology)
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
DR. GALON CORY MORGAN MD
Radiology (Diagnostic Radiology)
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
THOMAS ALAN GERBUS MD
Emergency Medicine
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
MR. DUSTIN LUU DO
Student in an Organized Health Care Education/Training Program
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
R MARK HUFFMAN PLLC
Anesthesiology
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
LUIS MURCIA
Student in an Organized Health Care Education/Training Program
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 396-4075
BAILEY KRAIS MSN, APRN, NNP-BC
Nurse Practitioner (Neonatal)
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800
DR. BAO-TRAM XUAN NGUYEN MD
Radiology (Neuroradiology)
3901 W 15TH ST
PLANO, TX 75075
Collin County (972) 596-6800

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 Ethan Pavlovsky's NPI number?

The NPI number for Ethan Pavlovsky is 1407505233. It was assigned to this individual provider in the NPPES registry on March 20, 2022.

Where is Ethan Pavlovsky located?

Ethan Pavlovsky practices at 3901 W 15th St, Plano, TX 75075. The listed phone number is (972) 396-4075.

What is Ethan Pavlovsky's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Ethan Pavlovsky enrolled in Medicare?

Yes. Ethan Pavlovsky is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Pavlovsky was last updated on March 8, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.