Ethan Benjamin Koch, MD - Medicare Pain Medicine in Saint Cloud, MN

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Ethan Benjamin Koch, MD is a medicare enrolled "Pain Medicine - Pain Medicine" physician in Saint Cloud, Minnesota. His current practice location is 4801 Veterans Dr, Saint Cloud, Minnesota. You can reach out to his office (for appointments etc.) via phone at (320) 252-1670.

Ethan Benjamin Koch is licensed to practice in Minnesota (license number 71757) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1023514007.

Contact Information

Ethan Benjamin Koch, MD
4801 Veterans Dr,
Saint Cloud, MN 56303-2015
(320) 252-1670
Not Available

Map and Direction




Physician's Profile

Full NameEthan Benjamin Koch
GenderMale
SpecialityPain Medicine - Pain Medicine
Location4801 Veterans Dr, Saint Cloud, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1023514007
  • Provider Enumeration Date: 03/30/2018
  • Last Update Date: 04/03/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 3274916606
  • Enrollment ID: I20220818001032

Medical Identifiers

Medical identifiers for Ethan Benjamin Koch such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023514007NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208100000XPhysical Medicine & Rehabilitation 71757 (Minnesota)Secondary
208D00000XGeneral Practice 71757 (Minnesota)Secondary
208VP0000XPain Medicine - Pain Medicine 71757 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Benjamin Koch allows following entities to bill medicare on his behalf.
Entity NameSunny S Kim Md Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659301992
PECOS PAC ID: 5799788386
Enrollment ID: O20060822000124
Entity NameSignify Health Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20200116002549

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Benjamin Koch is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ethan Benjamin Koch, MD
4801 Veterans Dr,
Saint Cloud, MN 56303-2015

Ph: (320) 252-1670		Ethan Benjamin Koch, MD
4801 Veterans Dr,
Saint Cloud, MN 56303-2015

Ph: (320) 252-1670

Reviews and Comments


Pain Medicine Doctors in Saint Cloud, MN


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.