KORNELIS POELSTRA (M.D.) – Orthopaedic Surgery of the Spine Physician, NPI 1467496828

KORNELIS POELSTRA (M.D.) is a healthcare provider. based in Henderson, Nevada. specializing in ORTHOPEDIC SURGERY. They hold the professional credentials M.D.. They hold a License No. 20020 (NV). The NPI Number for KORNELIS POELSTRA (M.D.) is 1467496828

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
KORNELIS POELSTRA (M.D.)
NPI
1467496828
Phone
(702) 320-8111
Address
3175 Saint Rose Pkwy Ste 121
Enumeration Date
16 June 2006
Last Update Date
9 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7023208111
Graduation Year
1997 (29 years ago)
PAC ID
6507868593
Group Practice PAC ID
4981678695
Professional Enrollment ID
I20201015003127
Address ID
NV891283157LA7140XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness85
Years active:19State licenses:1Digital endpointsOther names

252 ORTHOPEDIC SURGERY in NV

Provider Addresses for KORNELIS POELSTRA (M.D.)

  • 3175 Saint Rose Pkwy Ste 121

    Henderson, NV 890523507

    Phone: (702) 320-8111

    Fax: (702) 320-8112

    Type: Location

  • 7455 W Washington Ave Ste 480

    Las Vegas, NV 891284338

    Phone: (702) 320-8111

    Fax: (702) 320-8112

    Type: Location

  • 7140 SMOKE RANCH RD STE 150

    LAS VEGAS, NV 891283157

    Phone: (702) 320-8111

    Fax: (702) 320-8112

    Type: Location

  • Dardanelli Lane, Santina Community, Campbell, Santa Clara County, California, 95008, United States

    LOS GATOS, CA 950321418

    Phone: (408) 412-8110

    Fax: (408) 412-8499

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 182 Open Payments records for all available years, with a total value of $349,136.

Total Amount is formed as General ($349,136) + Research ($0) + Ownership ($0) = $349,136.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Stryker Corporation ($252,252).

Total Amount

$349,136

General + Research + Ownership

Payments

182

Total payment records

General Amount

$349,136

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

4

Ownership records

Last Payment Date

2024-12-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201015003127IOrthopedic SurgeryNVTBD
I20221122001706IOrthopedic SurgeryNJTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9067$0
72100X-ray of lower and sacral spine, 2-3 views5346$0
99214Established patient office or other outpatient visit, 30-39 minutes4233$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg3411$0
22853Insertion of cage or mesh device to spine bone and disc space during spine fusion2214$0
View full utilization report →

Insurance plans in this area (ZIP 89052)

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Provider's Procedures

KORNELIS POELSTRA (M.D.) performs procedures in ORTHOPEDIC SURGERY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYFL22842Insertion of posterior spinal instrumentation for spinal stabilization, 3 to 6 vertebral segments8077

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981678695View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNV
Orthopedic SurgeryNV
Physician AssistantNV
Certified Registered Nurse Anesthetist (Crna)NV
A N E S T H E S I O L O G YNV
Certified Registered Nurse Anesthetist (Crna)NV
Orthopedic SurgeryIL
Physical Medicine And RehabilitationNV
Physician AssistantNV
Rheumatology, Internal MedicineNV

Reviews

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Frequently asked questions

Is KORNELIS POELSTRA (M.D.) listed with a National Provider Identifier?
Yes — KORNELIS POELSTRA (M.D.) has NPI 1467496828 on file in the registry.
Active or inactive — what applies to KORNELIS POELSTRA (M.D.)?
You should see KORNELIS POELSTRA (M.D.) as active in CMS-hosted NPPES data.
What area of care is associated with KORNELIS POELSTRA (M.D.)?
KORNELIS POELSTRA (M.D.)'s record emphasizes Orthopaedic Surgery of the Spine Physician. Clinical services aligned with this taxonomy classification.
Where in Nevada is KORNELIS POELSTRA (M.D.) registered?
Use Henderson, Nevada as the headline location for KORNELIS POELSTRA (M.D.) here.
What does 6 location(s) imply?
6 practice locations appear in the available data.

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