ETHAN BENJAMIN KOCH MD
NPI 1023514007
Pain Medicine - Pain Medicine in Saint Cloud, MN

Q: What is Ethan Koch's NPI number?

The NPI number for Ethan Koch is 1023514007. It was assigned to this individual provider in the NPPES registry on March 30, 2018.

Q: What is Ethan Koch's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Koch was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.

Active since March 30, 2018PECOS Enrolled

4801 VETERANS DR, SAINT CLOUD, MN 56303(320) 252-1670 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 3, 2025, Jun 7, 2023, Sep 28, 2022 and 2 more (5 updates tracked since 2018).

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About Ethan Benjamin Koch Md NPPES

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

ETHAN BENJAMIN KOCH MD (NPI 1023514007) is an individual pain medicine provider in Saint Cloud, Minnesota, licensed in Minnesota (71757) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023514007

Entity TypeIndividualMale

Primary Taxonomy208VP0000X

Provider Legal NameETHAN BENJAMIN KOCHCredential: MD

Location Address4801 VETERANS DRSaint Cloud, MN 56303-2015

Mailing Address4801 Veterans DrSaint Cloud, MN 56303-2015 · (320) 252-1670

Phone(320) 252-1670

Sole ProprietorNo

Enumeration DateMarch 30, 2018

Last NPPES UpdateApril 3, 20255 updates tracked since enumeration

NPPES CertifiedMarch 17, 2025

✔ NPI 1023514007 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0000X

License✔ Licensed in MN · 71757

Definition

Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 71757 (MN)

Also ListedGeneral PracticeTaxonomy 208D00000X · License 71757 (MN)

4801 VETERANS DR, Saint Cloud, MN 56303

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 Reassignment

Medicare enrollment records show Ethan Koch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sunny S. Kim, MD PA

72 mi

Orthopaedic Surgery of the Spine

1601 HIGHWAY 13 E STE 100
Burnsville, MN 55337

Reassigned Medicare billing, Minnesota enrollment
4 clinicians in this Medicare group

NPI 1659301992 (320) 763-8888

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 56303 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

$127.61 typical visit price

range $56.00 – $168.28

Typical copayment $31.90 (range $14.00 – $42.07)

Most-billed visit code 99204

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA ANN MEYER LICSW

Social Worker (Clinical)