Provider Type Icon

ETHAN CHAUNCEY KORNGOLD MD NPI 1568452738


NPI Information

NPI: 1568452738
Provider Name: ETHAN CHAUNCEY KORNGOLD, MD
Classification: Internal Medicine - 207RI0011X
Entity Type: Individual

Specialization: Interventional Cardiology

PECOS Registration: Yes

Address:
9427 SW BARNES RD
SUITE 498
PORTLAND, OR
ZIP 97225
Phone: (503) 216-0900
Get Directions

Ethan Chauncey Korngold, MD is an interventional cardiology internal medicine in Portland, OR with 23 years of experience. The provider is an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. Ethan Chauncey Korngold, MD NPI is 1568452738. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2001

The provider's business location address is:

9427 SW BARNES RD
SUITE 498
PORTLAND, OR
ZIP 97225-652
Phone: (503) 216-0900

The NPI 1568452738 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)
  • Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers (HCPCS:93971)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
  • Replacement of aortic valve with prosthetic valve, accessed through the skin (HCPCS:33361)
  • Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)
  • Ultrasound study of arteries and arterial grafts of both legs (HCPCS:93925)
  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)

The enumeration date for this NPI number is 10/27/2005 and was last updated on 3/19/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine217916MASSACHUSETTSNo
2207RC0000XInternal MedicineCardiovascular Disease217916MASSACHUSETTSNo
3207RC0000XInternal MedicineCardiovascular DiseaseMD29224OREGONNo
4207RI0011XInternal MedicineInterventional CardiologyMD29224OREGONYes
5207RI0011XInternal MedicineInterventional CardiologyMD60107167WASHINGTONNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P00848656OTHEROREGONRR MEDICARE
2500609355MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.