ETHAN BENJAMIN KOCH (MD) – Pain Medicine Physician, NPI 1023514007
Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ETHAN BENJAMIN KOCH (MD)
4801 VETERANS DR
SAINT CLOUD, MN 563032015
Phone: (320) 252-1670
Type: Mailing
625 MONROE ST NE APT 423
WASHINGTON, DC 200171782
Phone: (917) 576-6994
Type: Mailing
Tisch Hospital, 550, 1st Avenue, Kips Bay, Manhattan Community Board 6, Manhattan, New York County, New York, 10016, United States
NEW YORK, NY 100166402
Phone: (212) 263-7300
Fax: (212) 420-2000
Type: Location
1601 HIGHWAY 13 E STE 100
BURNSVILLE, MN 553376847
Phone: (952) 405-9760
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $134.
Total Amount is formed as General ($134) + Research ($0) + Ownership ($0) = $134.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: SI-BONE, INC. ($134).
Total Amount
$134
General + Research + Ownership
Payments
2
Total payment records
General Amount
$134
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SI-BONE, INC. | $134 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-08-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220818001032 | I | Physical Medicine And Rehabilitation | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97140 | Therapy procedure using manual technique, each 15 minutes | 88 | 12 | $0 |
| 97813 | Acupuncture with electrical stimulation, initial 15 minutes | 67 | 16 | $0 |
| 97814 | Acupuncture with electrical stimulation, each additional 15 minutes | 67 | 16 | $0 |
| J2795 | Injection, ropivacaine hydrochloride, 1 mg | 53 | 12 | $0 |
| 20553 | Injection of trigger points, 3 or more muscles | 50 | 14 | $0 |
Insurance plans in this area (ZIP 56303)
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