Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Annika Svea Kostrubala, PA

Individual provider Physician Assistant · NPI 1750647244

Annika Svea Kostrubala, PA is a Physician Assistant in Fort Collins, Colorado. Graduated from Wayne State University School of Medicine in 2012, 14 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Colorado and South Carolina.

Years since qualifying
14
Trained at
Wayne State University School of Medicine
Licensed in
CO, SC
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2121 E Harmony Rd Unit 300
Fort Collins, CO 80528
Phone: (970) 224-9102
Fax: (970) 224-9112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA.0004033 (CO)
Physician Assistant Taxonomy 363A00000X · Licence 2701 (SC)

Record details

NPI number1750647244
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 9, 2012
Last updated in NPPESJanuary 8, 2024
Certification dateJanuary 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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