ETHAN THAUT – Physician Assistant, NPI 1417681255

ETHAN THAUT is a healthcare provider. based in Sioux city, Iowa. specializing in PHYSICIAN ASSISTANT. The NPI Number for ETHAN THAUT is 1417681255

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
ETHAN THAUT
NPI
1417681255
Phone
(712) 279-2010
Address
801 5TH ST
Enumeration Date
15 July 2022
Last Update Date
15 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7122792010
Graduation Year
2022 (4 years ago)
PAC ID
2163808452
Group Practice PAC ID
3173906088
Professional Enrollment ID
I20221011001020
Address ID
IA511011326SI801XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:3State licenses:0Digital endpointsOther names

1,648 PHYSICIAN ASSISTANT in IA

Provider Addresses for ETHAN THAUT

  • 801 5TH ST

    SIOUX CITY, IA 511011326

    Phone: (712) 279-2010

    Type: Location

  • 327 LAKESHORE DR

    NORTH SIOUX CITY, SD 570494002

    Phone: (307) 337-6943

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221011001020IPhysician AssistantIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes189174$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 51101)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173906088View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineNE
Physician AssistantIA
Internal MedicineNY
Nurse PractitionerIOWA
Internal MedicineMI
Family PracticeIA
Nurse PractitionerSD
Hospitalist, Family PracticeIA
Physician AssistantIN
Internal MedicineMI

Reviews

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Frequently asked questions

What number should I use to identify ETHAN THAUT for billing?
Administrative and clinical systems typically use NPI 1417681255 for ETHAN THAUT.
Is ETHAN THAUT's NPI status active today?
Active status means ETHAN THAUT's NPI record is not deactivated in the public file.
How should patients interpret ETHAN THAUT's specialty?
The extract shows Physician Assistant for ETHAN THAUT. Clinical services aligned with this taxonomy classification.
What city is tied to ETHAN THAUT?
The directory associates ETHAN THAUT with Sioux City, Iowa. Check all listed addresses for suites or satellite offices.
Why is information missing for ETHAN THAUT?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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