NPI age
12 years
Enumerated 2013-09-04
● Active
Type 1 · Individual
Polina Kokoulina, PA-C
Kokoulina is 1 of 36 physician assistant providers in Boise and 1 of 97 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-04-06
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 97 active physician assistant providers in Idaho.
NPI age
12 years
≈ at median (13 yr)
State licenses
1 state
23% of peers hold multiple states
Subspecialties
0
56% of peers hold subspecialties
NPI lifetime · 2013 → 2026
2013-09Enumerated in NPPES
2013
2026
Where they practice
Practice location
900 N Liberty St, Ste 101
Boise, ID 837048704
Mailing address
3340 E Goldstone Way
Meridian, ID 836421026
Specialties
-
Physician Assistant PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 24 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.