Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Corey John Koll, PA-C

Individual provider Surgical Physician Assistant · NPI 1649787128

Corey John Koll, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Orthopaedic Associates of Grand Rapids PC, a 86-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Fax: (616) 464-6170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5601008527 (MI)

Record details

NPI number1649787128
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2018
Last updated in NPPESJanuary 5, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Orthopaedic Associates Of Grand Rapids Pc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Grand Rapids