NPIMap

Individual provider Active NPI

Kornelis Poelstra, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Las Vegas, NV
National Provider Identifier
1467496828
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
20020 Issued in NV
Practice address
7140 Smoke Ranch Rd Ste 150
Las Vegas, NV 89128-3157
Phone
(702) 320-8111
Fax
(702) 320-8112
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 20020 NV Primary

Addresses

Primary practice location

7140 Smoke Ranch Rd Ste 150
Las Vegas, NV 89128-3157

Mailing address

7140 Smoke Ranch Rd Ste 150
Las Vegas, NV 89128-3157
Phone (702) 320-8111

Other practice location 1

3175 Saint Rose Pkwy Ste 121
Henderson, NV 89052-3507
Phone (702) 320-8111

Other practice location 2

7455 W Washington Ave Ste 480
Las Vegas, NV 89128-4338
Phone (702) 320-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201015003127 NV Practitioner - Orthopedic Surgery 6507868593 Reassigns benefits to 1 organization
I20221122001706 NJ Practitioner - Orthopedic Surgery 6507868593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allegiant Institute Inc.Group PAC ID 4981678695, 19 clinicians

Practice addresses (Care Compare)

7140 Smoke Ranch Rd
Las Vegas, NV 89128-3157
Phone (702) 320-8111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion367
Laminectomy or laminotomy (partial removal of spine bones)38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20020NVMDPharmacist
D64182MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Institute of New Jersey, P.a. CurrentSince Jan 1, 2023 Accepting new patients
Rothman Orthopaedics of New Jersey, LLC Orthopaedic Surgery CurrentSince Jan 1, 2023 Accepting new patients
The Spine Institute at Orthopaedic Associates PL Orthopaedic Surgery PastSince Dec 1, 2009 Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Ascension Sacred Heart Emerald Coast Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
James Lawrence Kernan Hospital, Inc. Past Accepting new patients
Emerald Coast Hospitalist Inc Past Accepting new patients
El Camino Hospital Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Fort Walton Beach Medical Center, Inc. Past Accepting new patients
University of Maryland Medical Center, LLC Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

Interoperability endpoints

  • Direct secure messaging: kpoelstra@spineinstituteontheemeraldcoast.kareodirect.com

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1467496828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 SMOKE RANCH RD STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283157",
            "telephone_number": "702-320-8111",
            "fax_number": "702-320-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 SMOKE RANCH RD STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891283157",
            "telephone_number": "702-320-8111",
            "fax_number": "702-320-8112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3175 Saint Rose Pkwy Ste 121",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523507",
            "country_code": "US",
            "telephone_number": "702-320-8111",
            "fax_number": "702-320-8112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7455 W Washington Ave Ste 480",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891284338",
            "country_code": "US",
            "telephone_number": "702-320-8111",
            "fax_number": "702-320-8112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POELSTRA",
        "first_name": "KORNELIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NV",
            "license": "20020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.