POLINA KOKOULINA (PA-C) – Surgical Physician Assistant, NPI 1013342468
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,531 PHYSICIAN ASSISTANT in ID
Provider Addresses for POLINA KOKOULINA (PA-C)
900 N LIBERTY ST
STE 101
BOISE, ID 837048704
Phone: (208) 367-5050
Fax: (208) 367-5151
Type: Location
3340 E GOLDSTONE WAY
MERIDIAN, ID 836421026
Phone: (208) 367-5050
Fax: (208) 367-5151
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $162.
Total Amount is formed as General ($162) + Research ($0) + Ownership ($0) = $162.
Last reported payment date: 2024-08-19 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($121).
Total Amount
$162
General + Research + Ownership
Payments
3
Total payment records
General Amount
$162
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pacira Pharmaceuticals Incorporated | $121 |
| AstraZeneca Pharmaceuticals LP | $41 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-11-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131108000316 | I | Physician Assistant | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 25 | 17 | $0 |
Insurance plans in this area (ZIP 83704)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Audiologist | ID | |
| Orthopedic Surgery | ID | |
| - | ID | |
| - | UT | |
| Family Practice | ID | |
| - | ID | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | ID | |
| Interventional Cardiology | AR |
Reviews
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