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

NPI Status: Active since September 04, 2013

Contact Information

900 N LIBERTY ST
STE 101
BOISE, ID
ZIP 83704
Phone: (208) 367-5050
Fax: (208) 367-5151

Get Directions Reviews

  • Individual
  • Female
  • Years of Experience 13
  • Physician Assistant
  • Surgical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About POLINA KOKOULINA

This page provides the complete NPI Profile along with additional information for Polina Kokoulina, a provider established in Boise, Idaho with a medical specialization in Physician Assistant, focusing in surgical and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1013342468 assigned on September 2013. The practitioner's primary taxonomy code is 363AS0400X with license number PA-1093 (ID). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1013342468
Provider Name
POLINA KOKOULINA PA-C
Gender
Female
Entity Type
Individual
Location Address
900 N LIBERTY ST STE 101 BOISE, ID 83704
Location Phone
(208) 367-5050
Location Fax
(208) 367-5151
Mailing Address
3340 E GOLDSTONE WAY MERIDIAN, ID 83642
Mailing Phone
(208) 367-5050
Mailing Fax
(208) 367-5151
Medical School Name
OTHER
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
09-04-2013
Last Update Date
04-06-2015
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA-1093
License State
ID

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Moda Health Affinity Bronze 7750 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • Moda Select Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Bronze HDHP 7500 - EPO
  • Moda Select Gold 1000 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Gold 1800 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 3500 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 4800 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 6400 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Connect Bronze Expanded Standard - PPO
  • Connect Bronze HDHP - PPO
  • Connect Catastrophic - PPO
  • Connect Gold - PPO
  • Connect Gold Standard - PPO
  • Connect Silver - PPO
  • Connect Silver Standard - PPO
  • High Plains Bronze HDHP - PPO
  • High Plains Bronze Standard Expanded - PPO
  • High Plains Gold - PPO
  • High Plains Gold HDHP - PPO
  • High Plains Gold Standard - PPO
  • High Plains Silver - PPO
  • High Plains Silver Standard - PPO
  • Plus Bronze Expanded - PPO
  • Plus Bronze Standard Expanded - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • ACCESS BRONZE - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Polina Kokoulina is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Polina Kokoulina is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4183859606

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20131108000316

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 11 times for 11 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Polina Kokoulina is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SAINT ALPHONSUS REGIONAL MEDICAL CENTER1055 NORTH CURTIS ROAD
BOISE, ID 83706
(208) 367-3554Acute Care Hospitals

Reviews for POLINA KOKOULINA PA-C

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013342468
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2023644412
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 6 + 4 + 4 + 4 + 1 + 2 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1013342468 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1972595676MRS. DANA SATOMI OWEN D.P.M.
Individual
Podiatrist900 N LIBERTY ST SUITE 306
BOISE, ID 83704
(208) 367-7887
1306838016MR. JAMES JOSEPH OWEN D.P.M.
Individual
Podiatrist900 N LIBERTY ST SUITE 306
BOISE, ID 83704
(208) 367-7887
1225011893DR. ERIC T GARNER M.D.
Individual
Otolaryngology (Otolaryngology/Facial Plastic Surgery)900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1659354223DR. ARTHUR JONES III M.D.
Individual
Otolaryngology900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1306829973DR. TODD RUSTAD M.D.
Individual
Otolaryngology900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1992788434DR. MATTHEW B SCHWARZ M.D.
Individual
Otolaryngology900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1306823125SOUTHWEST IDAHO EAR, NOSE AND THROAT
Organization
Otolaryngology900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1669416954 RENEE A BOBROWSKI MD
Individual
Obstetrics & Gynecology (Maternal & Fetal Medicine)900 N LIBERTY ST SUITE 206
BOISE, ID 83704
(208) 367-5544
1699711069SAINT ALPHONSUS PHYSICIANS PA
Organization
Obstetrics & Gynecology (Maternal & Fetal Medicine)900 N LIBERTY ST STE 206
BOISE, ID 83704
(208) 367-5544
1962438382 VALERIE A DAWIDCZIK NP
Individual
Nurse Practitioner900 N LIBERTY ST SUITE 302
BOISE, ID 83704
(208) 322-1686
1487682456DR. RITA ANN HARDING DDS
Individual
Dentist900 N LIBERTY ST SUITE 304
BOISE, ID 83704
(208) 375-0665
1487849147SAINT ALPHONSUS PHYSICIAN SERVICES INC
Organization
Obstetrics & Gynecology900 N LIBERTY ST SUITE 204
BOISE, ID 83704
(208) 367-4529
1548433790ADA PLASTIC AND RECONSTRUCTIVE SURGERY
Organization
Clinic/Center (Ambulatory Surgical)900 N LIBERTY ST SUITE 300
BOISE, ID 83704
(208) 367-6903
1538456900 MICHAEL DEAN BATEMAN AU.D.
Individual
Audiologist900 N LIBERTY ST STE 400
BOISE, ID 83704
(208) 367-3320
1184657389TREASURE VALLEY CARDIOLOGY PC
Organization
Internal Medicine (Cardiovascular Disease)900 N LIBERTY ST SUITE 302
BOISE, ID 83704
(208) 322-1686
1669470274 GERARD PATRICK CONNOR MD
Individual
Obstetrics & Gynecology (Gynecologic Oncology)900 N LIBERTY ST STE 101
BOISE, ID 83704
(208) 367-5050
1336309434 LINSEY ETHERINGTON MD
Individual
Surgery (Plastic and Reconstructive Surgery)900 N LIBERTY ST STE 101
BOISE, ID 83704
(208) 367-5050
1649212119 CHRISTINA M KNUTSON MD
Individual
Obstetrics & Gynecology900 N LIBERTY ST SUITE 204
BOISE, ID 83704
(208) 302-1200
1659909935MRS. EMILY DAWN CLAY RDN, LD
Individual
Dietitian, Registered900 N LIBERTY ST
BOISE, ID 83704
(208) 367-7190
1629031760SWIENT, LLC
Organization
Clinic/Center (Radiology)900 N LIBERTY ST SUITE 305
BOISE, ID 83704
(208) 367-3320

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013342468, enumerated in the NPI registry as an "individual" on September 04, 2013

The provider is located at 900 N Liberty St Ste 101 Boise, Id 83704 and the phone number is (208) 367-5050

The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical

The provider has more than 13 years of experience.

The provider might be accepting Accepts: Moda Health Plan, Inc. and Mountain Health CO-OP. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes.

The practitioner is affiliated to the following hospital(s): SAINT ALPHONSUS REGIONAL MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on September 04, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.