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

Individual provider Surgical Physician Assistant · NPI 1033510508

Theresa Koppal, PA-C is a Physician Assistant in Gilbert, Arizona. Qualified in 2014, 12 years ago. Practices with Orthopedic Specialists of North America PLLC, a 309-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
12
Licensed in
AZ
In the registry since
2014
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

2940 E Banner Gateway Dr Ste 200-250
Gilbert, AZ 85234-2168
Phone: (602) 548-5444
Fax: (602) 772-3801
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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 5748 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 5748 (AZ)

Record details

NPI number1033510508
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 15, 2014
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Orthopedic Specialists Of North America Pllc — 309 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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