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POLINA KOKOULINA PA-C
NPI 1013342468
Physician Assistant - Surgical in Boise, ID

Active since September 04, 2013PECOS EnrolledAccepts Medicare Assignment
900 N LIBERTY ST, STE 101, BOISE, ID 83704(208) 367-5050(208) 367-5151 Get Directions Write a Review

NPPES record last updated: April 6, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Polina Kokoulina Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

POLINA KOKOULINA PA-C (NPI 1013342468) is an individual surgical provider in Boise, Idaho, licensed in Idaho (PA-1093) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS, is affiliated with Saint Alphonsus Regional Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1013342468
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NamePOLINA KOKOULINACredential: PA-C
Location Address900 N LIBERTY ST, STE 101Boise, ID 83704-8704
Mailing Address3340 E Goldstone WayMeridian, ID 83642-1026 · (208) 367-5050 · Fax (208) 367-5151
Phone(208) 367-5050
Fax(208) 367-5151
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateSeptember 4, 2013
Last NPPES UpdateApril 6, 2015
✔ NPI 1013342468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in ID · PA-1093
900 N LIBERTY ST, Boise, ID 83704
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Polina Kokoulina Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4183859606
PECOS Enrollment IDI20131108000316
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
26 services15 patients
Removal of uterus, tubes, and/or ovaries through abdomen using an endoscope, 250.0 g or less 58571
This procedure involves the removal of certain internal structures through small incisions in the abdomen, using a special tool called an endoscope. It's performed when these structures are causing health issues. The weight reference (250.0 g or less) relates to the size of the structures being removed.
13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Alphonsus Regional Medical Center

Acute Care Hospitals · Boise, ID
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number130007
Location1055 North Curtis RoadBoise, ID 83706 · Ada County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TREASURE VALLEY CARDIOLOGY PC
Internal Medicine (Cardiovascular Disease)
900 N LIBERTY ST, SUITE 302
BOISE, ID 83704
Ada County (208) 322-1686
DR. ERIC T GARNER M.D.
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
900 N LIBERTY ST, STE 400
BOISE, ID 83704
Ada County (208) 367-3320
SOUTHWEST IDAHO EAR, NOSE AND THROAT
Otolaryngology
900 N LIBERTY ST, STE 400
BOISE, ID 83704
Ada County (208) 367-3320
DR. TODD RUSTAD M.D.
Otolaryngology
900 N LIBERTY ST, STE 400
BOISE, ID 83704
Ada County (208) 367-3320
MR. JAMES JOSEPH OWEN D.P.M.
Podiatrist
900 N LIBERTY ST, SUITE 306
BOISE, ID 83704
Ada County (208) 367-7887
LINSEY ETHERINGTON MD
Surgery (Plastic and Reconstructive Surgery)
900 N LIBERTY ST, STE 101
BOISE, ID 83704
Ada County (208) 367-5050
SOUTHWEST IDAHO SURGERY CENTER, INC.
Clinic/Center (Ambulatory Surgical)
900 N LIBERTY ST, SUITE 450
BOISE, ID 83704
Ada County (208) 367-7431
DR. RITA ANN HARDING DDS
Dentist
900 N LIBERTY ST, SUITE 304
BOISE, ID 83704
Ada County (208) 375-0665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Polina Kokoulina's NPI number?

The NPI number for Polina Kokoulina is 1013342468. It was assigned to this individual provider in the NPPES registry on September 4, 2013.

Where is Polina Kokoulina located?

Polina Kokoulina practices at 900 N Liberty St Ste 101, Boise, ID 83704. The listed phone number is (208) 367-5050.

What is Polina Kokoulina's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Polina Kokoulina enrolled in Medicare?

Yes. Polina Kokoulina is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Polina Kokoulina accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Polina Kokoulina as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Polina Kokoulina affiliated with any hospitals?

According to CMS data, Polina Kokoulina is affiliated with Saint Alphonsus Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Polina Kokoulina was last updated on April 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.