Organization Active NPI

Visser Health LLC

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1063372258
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VISSER HEALTH LLC
Practice address
1892 SW Gatlin Blvd
Port Saint Lucie, FL 34953
Phone
(772) 475-5369
Fax
(772) 213-0304
NPI assigned
Nov 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Jessica Visser, MDNPI 1912249756
Title
Physician Owner
Phone
(772) 475-5369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1892 SW Gatlin Blvd
Port Saint Lucie, FL 34953

Mailing address

1892 SW Gatlin Blvd
Port Saint Lucie, FL 34953
Phone (772) 475-5369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260505001188 FL Part B Supplier - Clinic/Group Practice 4688142029 Receives reassigned benefits from 1 practitioner
Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory

Locations

1892 SW Gatlin Blvd
Port St Lucie, FL 34953
Phone (772) 475-5369

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1063372258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 SW GATLIN BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-475-5369",
            "fax_number": "772-213-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 SW GATLIN BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-475-5369",
            "fax_number": "772-213-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISSER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "VISSER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "772-475-5369",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.