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ETHAN PRINCE
NPI 1306064563
Radiology - Vascular & Interventional Radiology in Edina, MN

Active since April 23, 2007PECOS Enrolled
83.6/100
CMS Quality Rating
3600 MINNESOTA DR STE 800, EDINA, MN 55435(952) 595-1100 Get Directions Write a Review

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 4, 2026, Apr 4, 2019 (2 updates tracked since 2019).

About Ethan Prince NPPES

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

ETHAN PRINCE (NPI 1306064563) is an individual vascular & interventional radiology provider in Edina, Minnesota, licensed in Rhode Island (12864) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1306064563
Entity TypeIndividualMale
Primary Taxonomy2085R0204X
Provider Legal NameETHAN PRINCE
Location Address3600 MINNESOTA DR STE 800Edina, MN 55435-7915
Mailing Address3600 Minnesota Dr Ste 800Edina, MN 55435-7915 · (952) 595-1100
Phone(952) 595-1100
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateApril 23, 2007
Last NPPES UpdateMarch 4, 20262 updates tracked since enumeration
NPPES CertifiedMarch 4, 2026
✔ NPI 1306064563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
License✔ Licensed in RI · 12864
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License MD12864 (RI)
3600 MINNESOTA DR STE 800, Edina, MN 55435
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)

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

PECOS PAC ID749332237
PECOS Enrollment IDI20220916002345
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 55435 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.37
Improvement Activities40
Cost60.92

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.

CHRISTOPHER CALIXTE MD
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1100
PAUL D GUISLER MD
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1301
KRISHNA VAIDYANATHAN IYER M.D.
Radiology (Vascular & Interventional Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1100
RATI NARENDRA PATEL MD
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1301
SUSANNE S. KIM M.D.
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1301
GWENDOLYN DURGIN MD
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1301
ROBERT L EDWARDS M.D.
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1100
STEPHEN GEORGE FOX M.D.
Radiology (Diagnostic Radiology)
3600 MINNESOTA DR STE 800
EDINA, MN 55435
Hennepin County (952) 595-1100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Prince's NPI number?

The NPI number for Ethan Prince is 1306064563. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Ethan Prince located?

Ethan Prince practices at 3600 Minnesota Dr Ste 800, Edina, MN 55435. The listed phone number is (952) 595-1100.

What is Ethan Prince's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Is Ethan Prince enrolled in Medicare?

Yes. Ethan Prince is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Prince was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.