DR. ETHAN MICHAEL KALLENBERGER MD
NPI 1043103963
Otolaryngology in Charleston, SC

Q: What is Ethan Kallenberger's NPI number?

The NPI number for Ethan Kallenberger is 1043103963. It was assigned to this individual provider in the NPPES registry on May 30, 2025.

Q: What is Ethan Kallenberger's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Active since May 30, 2025PECOS Enrolled

169 ASHLEY AVE # MSC333, CHARLESTON, SC 29425(843) 792-7365 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 30, 2025, May 30, 2025 (2 updates tracked since 2025).

On this page

About Dr. Ethan Michael Kallenberger Md NPPES

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

DR. ETHAN MICHAEL KALLENBERGER MD (NPI 1043103963) is an individual otolaryngology provider in Charleston, South Carolina, licensed in South Carolina (LL94805) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043103963

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameDR. ETHAN MICHAEL KALLENBERGERCredential: MD

Location Address169 ASHLEY AVE # MSC333Charleston, SC 29425-8905

Mailing Address169 Ashley Ave Rm 202Charleston, SC 29425-8905

Phone(843) 792-7365

Sole ProprietorNo

Enumeration DateMay 30, 2025

Last NPPES UpdateJune 30, 20252 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1043103963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in SC · LL94805

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

169 ASHLEY AVE # MSC333, Charleston, SC 29425

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan Michael Kallenberger 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 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

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

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 10

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

GRIFFIN JOHN SALZER

Emergency Medicine