DR. KORNELIS POELSTRA (NPI# 1467496828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467496828 |
| Entity Type | Individual |
| Full Name | DR. KORNELIS POELSTRA |
| Credential | M.D. |
| Practice Address |
340 Dardanelli Ln Ste 10 Los Gatos CA 95032 |
| Mailing Address |
340 Dardanelli Ln Ste 10 Los Gatos CA 95032-1418 |
| Practice Telephone | 4084128110 |
| Practice Fax Number | 4084128499 |
| Mailing Telephone | 4084128110 |
| Mailing Fax Number | 4084128499 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207PS0010X |
Emergency Medicine Specialization: Sports Medicine |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
ME105637 | FL | Allopathic & Osteopathic Physicians |
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
D0064282 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001556000 | 05 | |
| MD | 009808600 | 05 | |
| MD | STATE LICENSE NUMBER | D0064282 | 01 |
| AL | BCBS OF ALABAMA | 593-09767 | 01 |
| CA | MEDICARE PTAN | CA362605 | 01 |
| CA | STATE LICENSE | C154182 | 01 |
| FL | LICENSE | ME 105637 | 01 |
| AL | BCBS OF ALABAMA | 593-09895 | 01 |
| CA | MEDICARE PIN | CA362605 | 01 |
| FL | FLORIDA BLUE | 146PG | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 155 Crystal Beach Dr, Suite200, Destin, FL 325413527 | 8504602350 | 8504602351 |
| Street Address |
340 DARDANELLI LN STE 10 |
| City | LOS GATOS |
| State | CA |
| Zip Code | 95032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912962556 | Jeffrey Scott Kanel | Orthopaedic Surgery | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2006-04-18 |
| 1508334863 | Jan Kenneth Banting | Physical Therapist | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2018-11-05 |
| 1952876922 | Ashley Marie Sauter | Physician Assistant | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2018-10-05 |
| 1285137588 | Carrie Ann Clark | Clinical Nurse Specialist | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2018-03-13 |
| 1255869178 | Chelsea Jordan Lawrance | Physician Assistant | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032 | 2017-05-24 |
| 1124398235 | Orthonorcal, Inc. | Orthopaedic Surgery | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2012-01-05 |
| 1063707313 | Robert Anthony Cagle | Orthopaedic Surgery | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2011-06-15 |
| 1992010110 | Kathleen Le Lew | Physician Assistant | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032 | 2010-08-12 |
| 1538480082 | Erica Elizabeth Fisk | Orthopaedic Surgery | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032 | 2010-06-18 |
| 1801002134 | Sandeep Gidvani | Orthopaedic Surgery | 340 Dardanelli Ln Ste 10, Los Gatos, CA 95032-1418 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346730157 | Stephanie Chui | Optometrist | 15055 Los Gatos Blvd Ste 300, Los Gatos, CA 95032 | 2018-05-16 |
| 1710474960 | Lisa Richardson | Dietitian, Registered | 15405 Los Gatos Blvd #101, Los Gatos, CA 95032 | 2018-04-13 |
| 1235652934 | Nillofar Tabibi | Pharmacist | 1496 Pollard Road, Los Gatos, CA 95032 | 2017-07-25 |
| 1609397694 | Taylor Dolores Peterson | Marriage & Family Therapist | 15495 Los Gatos Blvd Ste 5, Los Gatos, CA 95032 | 2017-06-29 |
| 1942755418 | Michelle Sunalp | Physician Assistant | 14830 Los Gatos Blvd, Suite 300, Los Gatos, CA 95032 | 2016-08-24 |
| 1295196640 | Mandice Williams | Chiropractor | 236 Oak Meadow Dr, Los Gatos, CA 95032 | 2016-03-14 |
| 1922465020 | Los Gatos Dental Specialists | Dentist | 15075 Los Gatos Blvd, Ste 120, Los Gatos, CA 95032 | 2016-01-20 |
| 1962881813 | Los Gatos Snf, LLC | Skilled Nursing Facility | 16605 Lark Ave., Los Gatos, CA 95032 | 2015-05-26 |
| 1720404312 | Jonathan Davies | Physician Assistant | 15466 Los Gatos Blvd Ste 109-353, Los Gatos, CA 95032 | 2014-03-06 |
| 1588002612 | Jessica Velasco Gutierrez | Licensed Vocational Nurse | 634 W Parr Ave #116, Los Gatos, CA 95032 | 2013-06-11 |
| Find all providers in zip 95032 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265794754 | Ian J Barrett | Orthopaedic Surgery | 555 Knowles Dr Ste 200, Los Gatos, CA 95032-1551 | 2012-06-12 |
| 1689806812 | Rives C. Chalmers, M.d. A Prof Corp | Orthopaedic Surgery | 800 Pollard Rd Ste A3, Los Gatos, CA 95032-1432 | 2009-08-21 |
| 1952504771 | David Eirin Oji | Orthopaedic Surgery | 555 Knowles Dr Ste 211, Los Gatos, CA 95032-1551 | 2007-06-08 |
| 1033321203 | Frederic J Collins Md Inc | Orthopaedic Surgery | 101 Auzerais Ct., Los Gatos, CA 95032-5703 | 2007-05-03 |
| 1598808834 | Frederic James Collins | Orthopaedic Surgery | 101 Auzerais Ct, Los Gatos, CA 95032-5703 | 2007-02-15 |
| 1033252259 | John P Colman | Orthopaedic Surgery | 800 Pollard Rd Ste A2, Los Gatos, CA 95032-1432 | 2007-02-15 |
| 1922160399 | Theresa Colosi | Orthopaedic Surgery | 14901 National Ave 101, Los Gatos, CA 95032-2637 | 2006-12-14 |
| 1487713475 | Norman Robert Nedde | Orthopaedic Surgery | 111 Worcester Ln, Los Gatos, CA 95030-6323 | 2006-12-06 |
| 1982781951 | Wayne Stuart Chronister | Orthopaedic Surgery | 800 Pollard Rd Ste A6, Los Gatos, CA 95032-1432 | 2006-11-01 |
| 1972560217 | Paul Howard Dossick | Orthopaedic Surgery | 700 West Parr Ave., Suite D, Los Gatos, CA 95032-1416 | 2006-04-28 |
| Find all providers in LOS GATOS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.