Ethan Prince
NPI 1306064563ActiveIndividual· Radiology, Vascular & Interventional Radiology· Edina, MN
Radiology, Vascular & Interventional Radiology with Virtual Radiologic Professionals LLC, practicing in Edina, Minnesota. Enrolled in Medicare as practitioner - diagnostic radiology and practitioner - diagnostic radiology. Lists Endless Mountains Health Systems and 4 other hospitals as hospital affiliations.
Overview
| NPI | 1306064563 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 23, 2007 |
| Last updated in NPPES | Mar 4, 2026 |
| Certified by provider | Mar 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Vascular & Interventional Radiology Primary | 2085R0204X | 12864 | RI |
| Radiology, Diagnostic Radiology | 2085R0202X | MD12864 | RI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Diagnostic Radiology (CT); Practitioner - Diagnostic Radiology (RI) |
|---|
Education and affiliations
| Graduation year | 2000 |
|---|---|
| Medicare specialty | Diagnostic Radiology |
Medical group
- Virtual Radiologic Professionals LLCPensacola, FL · 397 clinicians
Hospital affiliations
- Endless Mountains Health SystemsMontrose, PA
- Gettysburg HospitalGettysburg, PA
- Pottstown HospitalPottstown, PA
- Wellspan Good Samaritan HospitalLebanon, PA
- Wellspan York HospitalYork, PA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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