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ETHAN SHORT MD
NPI 1629502604
Psychiatry & Neurology - Psychiatry in Louisville, KY

Active since April 17, 2017PECOS Enrolled
228 DELMONT AVE, LOUISVILLE, KY 40206(502) 619-0636 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 22, 2023, Jun 6, 2022, Feb 11, 2021 and 3 more (6 updates tracked since 2017).

About Ethan Short Md NPPES

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

ETHAN SHORT MD (NPI 1629502604) is an individual psychiatry provider in Louisville, Kentucky, licensed in Kentucky (54489) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Louisville, and is a graduate of University Of Louisville School Of Medicine (2022).

NPPES Registry Identity

NPI1629502604
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameETHAN SHORTCredential: MD
Location Address228 DELMONT AVELouisville, KY 40206-1025
Mailing Address228 Delmont AveLouisville, KY 40206-1025 · (502) 619-0636
Phone(502) 619-0636
Sole ProprietorYes
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2022
Enumeration DateApril 17, 2017
Last NPPES UpdateAugust 22, 20236 updates tracked since enumeration
NPPES CertifiedAugust 22, 2023
✔ NPI 1629502604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Licenses✔ Licensed in KY · 54489✔ Licensed in IN · 01091358A✔ Licensed in KY · R4865
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 54489 (KY)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
228 DELMONT AVE, Louisville, KY 40206
Open in Google Maps ↗

Secondary Practice Location 1

Location 15722 Outer LoopLouisville, KY 40219-4156 · Phone (502) 492-7455 · Fax (502) 921-0222

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Short Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID446665996
PECOS Enrollment IDI20210216002380, I20230922002634
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 Ethan Short reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespring, Inc
1.9 mi
Federally Qualified Health Center (FQHC)
404 SPRING ST
Jeffersonville, IN 47130
  • Reassigned Medicare billing, Indiana enrollment
  • 119 clinicians in this Medicare group
NPI 1861957706 (812) 206-1303
Wsh Holdings In LLC
117 mi
Psychiatry
9002 N MERIDIAN ST STE 200
Indianapolis, IN 46260
  • Reassigned Medicare billing, Indiana and Kentucky enrollments
  • 2 clinicians in this Medicare group
NPI 1487516860 (931) 801-8024

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40206 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$162.27 typical visit price
range $52.76 – $162.27
Typical copayment $40.56 (range $13.19 – $40.56)
Most-billed visit code 99205
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Short's NPI number?

The NPI number for Ethan Short is 1629502604. It was assigned to this individual provider in the NPPES registry on April 17, 2017.

Where is Ethan Short located?

Ethan Short practices at 228 Delmont Ave, Louisville, KY 40206. The listed phone number is (502) 619-0636.

What is Ethan Short's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Ethan Short enrolled in Medicare?

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

Which organizations bill Medicare for Ethan Short's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Short reassigns Medicare benefits to 2 organizations: Lifespring, Inc (Jeffersonville, IN) and Wsh Holdings In LLC (Indianapolis, IN). 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 Ethan Short's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Short accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare and UnitedHealthcare list Ethan Short as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Short was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.