ETHAN COUCKE DO
NPI 1487188710
Internal Medicine in Petoskey, MI

Q: What is Ethan Coucke's NPI number?

The NPI number for Ethan Coucke is 1487188710. It was assigned to this individual provider in the NPPES registry on April 13, 2017.

Q: What is Ethan Coucke's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Coucke was last updated on November 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 April 13, 2017PECOS EnrolledAccepts Medicare Assignment

416 CONNABLE AVE, PETOSKEY, MI 49770(231) 487-7969 Get Directions Write a Review

NPPES record last updated: November 29, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 29, 2022, Apr 13, 2017 (2 updates tracked since 2017).

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About Ethan Coucke Do NPPES

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

ETHAN COUCKE DO (NPI 1487188710) is an individual internal medicine provider in Petoskey, Michigan, licensed in Michigan (5101023447) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Mclaren Northern Michigan, and is a graduate of Michigan State University College Of Osteopathic Medicine (2017).

NPPES Registry Identity

NPI1487188710

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameETHAN COUCKECredential: DO

Location Address416 CONNABLE AVEPetoskey, MI 49770-2212

Mailing Address15235 Hough RdAllenton, MI 48002-3613 · (810) 656-1884

Phone(231) 487-7969

Sole ProprietorNo

Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2017

Enumeration DateApril 13, 2017

Last NPPES UpdateNovember 29, 20222 updates tracked since enumeration

NPPES CertifiedNovember 29, 2022

✔ NPI 1487188710 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MI · 5101023447

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

416 CONNABLE AVE, Petoskey, MI 49770

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Coucke Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305264235

PECOS Enrollment IDI20200909002453

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

109 services105 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

57 services57 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

16 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mclaren Northern Michigan

Acute Care Hospitals · Petoskey, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230105

Location416 Connable AvePetoskey, MI 49770 · Emmet County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49770 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

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers29 claims29 services$21.26 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers32 claims32 services$119.14 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

KEELY MARIE BLOSH NP

Nurse Practitioner