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

Individual provider Physician Assistant · NPI 1891315495

Stephanie Kourtjian, PA-C is a Physician Assistant in Madison, Wisconsin. Qualified in 2020, 6 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Wisconsin.

Years since qualifying
6
Licensed in
CO, WI
In the registry since
2020
Specialties on file
2
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

1240 University Bay Dr
Madison, WI 53705-2253
Phone: (616) 970-8072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2500 Rocky Mountain Ave Ste 310, Loveland, CO 80538-9004 — (970) 203-7110

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5374 (WI)
Physician Assistant Taxonomy 363A00000X · Licence PA.0008716 (CO)

Record details

NPI number1891315495
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 23, 2020
Last updated in NPPESDecember 26, 2024
Certification dateDecember 26, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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