Active NPI 1861016024 Individual Practitioner Male Practitioner

Dr. Ezra Koch , MD

General Practice • Mandan, ND

Professional Overview & Biography Verified Profile Summary

Dr. Ezra Koch, MD is a registered healthcare professional specializing in General Practice in Mandan, ND. Practice services are available at 4108 39TH AVE NW under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4108 39th Ave Nw

Mandan, ND 585541253

Telephone 7014264291

Associated Practice Facility / Clinic

🏢 Sickbay Pllc Facility NPI 1104525898

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Mandan, ND

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 38.0 Yrs

Regional Practice Density

1 Specialists

Practicing in Mandan, ND (16 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-03-01

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License ND 19404

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location March 01, 2023

Registered at 4108 39TH AVE NW, MANDAN, ND 585541253 (Tel: 7014264291)

📍

Updated Business Mailing Address March 01, 2023

Registered at 4108 39TH AVE NW, MANDAN, ND 585541253

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2023

General Practice (License #19404 in ND)

✅

NPI Profile Active June 03, 2020

NPI status registered as active in NPPES database

📍

Updated Practice Location June 03, 2020

Registered at 1301 N COLUMBIA RD, STOP 9037, UND DEPARTMENT OF SURGERY, GRAND FORKS, ND 582029037 (Tel: 7012934151)

📍

Updated Business Mailing Address June 03, 2020

Registered at 1301 N COLUMBIA RD, STOP 9037, UND DEPARTMENT OF SURGERY, GRAND FORKS, ND 582029037 (Tel: 7012934151)

👤

Provider Name / Credentials Updated June 03, 2020

Recorded as EZRA KOCH, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2020

Surgery (License #RL16585 in ND)

🟢

Initial NPI Registration & Enumeration June 03, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1861016024

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 03, 2020

Last Update: March 01, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

4108 39th Ave Nw

Mandan, ND 585541253

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.