Ethan Chauncey Korngold, MD - Medicare Interventional Cardiology in Portland, OR

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Ethan Chauncey Korngold, MD is a medicare enrolled "Internal Medicine - Interventional Cardiology" physician in Portland, Oregon. He went to Washington University School Of Medicine and graduated in 2001 and has 23 years of diverse experience with area of expertise as Interventional Cardiology. He is a member of the group practice Providence Health And Services Oregon, Providence Health And Services Oregon and his current practice location is 9427 Sw Barnes Rd, Suite 498, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 216-0900.

Ethan Chauncey Korngold is licensed to practice in Oregon (license number MD29224) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1568452738.

Contact Information

Ethan Chauncey Korngold, MD
9427 Sw Barnes Rd, Suite 498,
Portland, OR 97225-6652
(503) 216-0900
Not Available

Map and Direction




Physician's Profile

Full NameEthan Chauncey Korngold
GenderMale
SpecialityInterventional Cardiology
Experience23 Years
Location9427 Sw Barnes Rd, Portland, Oregon
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ethan Chauncey Korngold attended and graduated from Washington University School Of Medicine in 2001
  NPI Data:
  • NPI Number: 1568452738
  • Provider Enumeration Date: 10/27/2005
  • Last Update Date: 03/19/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0345248464
  • Enrollment ID: I20090826000937

Medical Identifiers

Medical identifiers for Ethan Chauncey Korngold such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568452738NPI-NPPES
P00848656OtherORRR MEDICARE
500609355MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 217916 (Massachusetts)Secondary
207RC0000XInternal Medicine - Cardiovascular Disease MD29224 (Oregon)Secondary
207RC0000XInternal Medicine - Cardiovascular Disease 217916 (Massachusetts)Secondary
207RI0011XInternal Medicine - Interventional Cardiology MD60107167 (Washington)Secondary
207RI0011XInternal Medicine - Interventional Cardiology MD29224 (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Providence St Vincent Medical CenterPortland, ORHospital
Providence Portland Medical CenterPortland, ORHospital
Providence Milwaukie HospitalMilwaukie, ORHospital
Providence Willamette Falls Medical CenterOregon city, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Health And Services Oregon06481836081344
Providence Health And Services Oregon9335057447137

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. Ethan Chauncey Korngold allows following entities to bill medicare on his behalf.
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023488343
PECOS PAC ID: 0648183608
Enrollment ID: O20031106000652
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003991845
PECOS PAC ID: 5395656284
Enrollment ID: O20031113000626
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114015971
PECOS PAC ID: 9335057447
Enrollment ID: O20031117000153
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093976243
PECOS PAC ID: 3476450560
Enrollment ID: O20031217000186
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578500492
PECOS PAC ID: 1557260106
Enrollment ID: O20040102000768
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366536963
PECOS PAC ID: 6103728753
Enrollment ID: O20040123000371
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952482275
PECOS PAC ID: 3072415652
Enrollment ID: O20040123000519
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053862714
PECOS PAC ID: 7315856010
Enrollment ID: O20040304001330
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568547503
PECOS PAC ID: 5294623245
Enrollment ID: O20040310000315

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. Ethan Chauncey Korngold 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
Ethan Chauncey Korngold, MD
Po Box 3158,
Portland, OR 97208-3158

Ph: () -		Ethan Chauncey Korngold, MD
9427 Sw Barnes Rd, Suite 498,
Portland, OR 97225-6652

Ph: (503) 216-0900

Reviews and Comments


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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