Individual provider Active NPI

Irina Gutsalyuk, PA

  • Physician Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1073522942
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109303 Issued in FL
Practice address
370 Southeast Veranda Falls Way
Suite 102
Port Saint Lucie, FL 34984
Phone
(772) 763-1720
Fax
(772) 214-3027
NPI assigned
Aug 7, 2006
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109303 FL Primary
Surgical Physician Assistant 363AS0400X 009810-1 NY

Addresses

Primary practice location

370 Southeast Veranda Falls Way
Suite 102
Port Saint Lucie, FL 34984

Mailing address

PO Box 20800
Belfast, ME 04915-4105
Phone (888) 402-7256

Other practice location 1

310 Southeast Veranda West Boulevard
Port Saint Lucie, FL 34984
Phone (772) 309-8500

Other practice location 2

3931 Louisana Ave. S.
St. Louis Park, MN 55426
Phone (952) 993-2079

Other names 1

  • Irina Tsur-Tsar Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908002290 FL Practitioner - Physician Assistant 3678633450 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1411 N Flagler Dr
Suite 8000
West Palm Beach, FL 33401-3413
Phone (561) 650-6231

900 SE Becker Rd
Port St Lucie, FL 34984-6641
Phone (772) 255-7550

901 Village Blvd
West Palm Beach, FL 33409-1947

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.5 of 100Reported as group
Quality
69.32
Promoting interoperability
100
Improvement activities
40
Cost
72.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109303FLMDPhysician Assistant
009810-1NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Palm Beach Physicians & Urgent Care, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Tenet Florida Physician Services LLC CurrentSince Mar 15, 2021 Accepting new patients

Locations

3650 NW 82nd Ave
Ste 502
Doral, FL 33166
Phone (305) 594-9333

8825 Perimeter Park Blvd
Ste 102
Jacksonville, FL 32216
Phone (904) 399-4004

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

4623 Forest Hill Blvd
Ste 101
West Palm Beach, FL 33415
Phone (561) 966-7194

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: irina.gutsalyuk.2@13023.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1073522942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20800",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154105",
            "telephone_number": "888-402-7256",
            "fax_number": "888-902-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 SOUTHEAST VERANDA FALLS WAY",
            "address_2": "SUITE 102",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "34984",
            "telephone_number": "772-763-1720",
            "fax_number": "772-214-3027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Southeast Veranda West Boulevard",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "34984",
            "country_code": "US",
            "telephone_number": "772-309-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3931 Louisana Ave. S.",
            "address_purpose": "LOCATION",
            "city": "St. Louis Park",
            "state": "MN",
            "postal_code": "55426",
            "country_code": "US",
            "telephone_number": "952-993-2079",
            "fax_number": "716-887-5045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTSALYUK",
        "first_name": "IRINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-07-03",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109303",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009810-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "TSUR-TSAR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.