Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Grant Novacinski

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083356406

Ethan Grant Novacinski is a Physician Assistant in Des Moines, Iowa. Qualified in 2023, 3 years ago. Practices with Centracare Clinic, a 782-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

3200 Grand Ave
Des Moines, IA 50312-4104
Phone: (515) 271-1569
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14620 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1083356406
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 7, 2022
Last updated in NPPESSeptember 27, 2023
Certification dateSeptember 27, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Centracare Clinic — 782 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Des Moines