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

Individual provider Physician Assistant · NPI 1720506959

Polina Koptelova, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Catawba Valley Medical Center, a 105-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2017
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

300 68th St SE
Grand Rapids, MI 49548-6927
Phone: (989) 854-0233
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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 5601008380 (MI)

Record details

NPI number1720506959
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 8, 2017
Last updated in NPPESSeptember 8, 2017

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 Catawba Valley Medical Center — 105 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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