Ezra Koch, MD - Medicare General Practice in Mandan, ND

Ezra Koch, MD is a medicare enrolled "General Practice" physician in Mandan, North Dakota. His current practice location is 4108 39th Ave Nw, Mandan, North Dakota. You can reach out to his office (for appointments etc.) via phone at (701) 426-4291.

Ezra Koch is licensed to practice in North Dakota (license number 19404) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861016024.

Contact Information

Ezra Koch, MD
4108 39th Ave Nw,
Mandan, ND 58554-1253
(701) 426-4291
Not Available



Physician's Profile

Full NameEzra Koch
GenderMale
SpecialityGeneral Practice
Location4108 39th Ave Nw, Mandan, North Dakota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1861016024
  • Provider Enumeration Date: 06/03/2020
  • Last Update Date: 03/01/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0941625214
  • Enrollment ID: I20230308002302

Medical Identifiers

Medical identifiers for Ezra Koch such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1861016024NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 19404 (North Dakota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ezra Koch allows following entities to bill medicare on his behalf.
Entity NameSignify Health Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20200303000565

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ezra Koch is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ezra Koch, MD
4108 39th Ave Nw,
Mandan, ND 58554-1253

Ph: () -
Ezra Koch, MD
4108 39th Ave Nw,
Mandan, ND 58554-1253

Ph: (701) 426-4291

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General Practice Doctors in Mandan, ND


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