Ethan John Chupka, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704315820 Issued in MI

Practice address

400 W 16TH St
Pueblo, CO 81003-2745

Phone

(719) 584-4045

Fax

(719) 542-0809

NPI assigned

Oct 27, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, OR, CO3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Colorado - Denver PC

  • Anesthesiology Physician
  • Denver, CO
  • NPI 1588453575

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• US Anesthesia Partners of Colorado Inc.

  • Anesthesiology Physician
  • Greenwood Village, CO
  • NPI 1922365782

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Kalamazoo Anesthesiology P C

  • Anesthesiology Physician
  • Kalamazoo, MI
  • NPI 1407821796
  Medicare reassignment NPD
• Northstar Anesthesia of Michigan II PC

  • Anesthesiology Physician
  • Irving, TX
  • NPI 1437268026

  MI, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Candace W Ross PHD LLC

  • Counseling Psychologist
  • Kalamazoo, MI
  • NPI 1336682988
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence Portland Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1659971034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-584-4045",
            "fax_number": "719-542-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-584-4045",
            "fax_number": "719-542-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUPKA",
        "first_name": "ETHAN",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "APN.1000360-CRNA",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704315820",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704315820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4704315820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher G. Vialpando M.D. PLLC
• Christopher R Dpersio DPM Prof LLC
• Christopher Y C Louie MD PC
• Chrysalisis; a New Shift in Life (Barbara Rae Frye)
• Nancy S Chuch, MD
• Jacqueline Ciancio
• Kristen Cicero
• Renee Hadad Cichon, AU.D.
• Katie Cira, PT, DPT
• Macie Cisneros, LPCC

• Certified Registered Nurse Anesthetist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Certified Registered Nurse Anesthetist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.