Active NPI
Ethan David Angle
- Surgery Physician
- Rochester, MN
National Provider Identifier
1821939810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 36277
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Apr 2, 2026
- Last updated
- Apr 22, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 36277 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260430000293 | MN | Order and Referring Only - General Surgery | 2567939218 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36277 | MN | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1821939810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860912",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860912",
"telephone_number": "507-284-2511",
"fax_number": "507-284-0702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGLE",
"first_name": "ETHAN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-02",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MN",
"license": "36277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
- Angela Appleman, OD PLLC
- Allison Marie Angeli, MD
- Camille Angelici, MA, LPCC
- Heather Lynn Angell, RN
- Grace Natalie Angelondous, APRN, CRNA, DNAP
- Kurt B Angstman, M.D.
- Ann Koranda (Change Counseling for Recovery)
- Anna Ryabova Counseling LLC Aletheia Counseling (Aletheia Counseling)
- Shejan Ansar
- Bijan Ansari Mohabadian, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.