Individual provider Active NPI

Marissa Macey Gosselin

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1487523627
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9121072 Issued in FL
Practice address
13685 Doctors Way Ste 100
Fort Myers, FL 33912-4337
Phone
(239) 343-1612
Fax
(239) 343-4229
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X G245553999050 FL
Physician Assistant 363A00000X PA9121072 FL Primary

Addresses

Primary practice location

13685 Doctors Way Ste 100
Fort Myers, FL 33912-4337

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-1612

Other practice location 1

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000

Other identifiers 1

IdentifierTypeStateIssuer
129420500MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgosselin703094@Direct.leememorial.org Direct LEE HEALTH SYSTEM INC

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
I20251204002792 FL Practitioner - Physician Assistant 1850884149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

13685 Doctors Way
Suite 100
Fort Myers, FL 33912-4337
Phone (239) 343-1612

Hospital & facility affiliations

  • Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G245553999050FLMDTrauma Surgery Physician
PA9121072FLMDPhysician Assistant

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Jan 16, 2026 Accepting new patients
Lee Health System Inc CurrentSince Jan 16, 2026 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

13685 Doctors Way
Ste 100
Fort Myers, FL 33912
Phone (239) 343-1176

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mgosselin703094@direct.leememorial.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1487523627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-1612",
            "fax_number": "239-343-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13685 DOCTORS WAY STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124337",
            "telephone_number": "239-343-1612",
            "fax_number": "239-343-4229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13681 Doctors Way",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124300",
            "country_code": "US",
            "telephone_number": "239-343-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "MARISSA",
        "middle_name": "MACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "G245553999050",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9121072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129420500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgosselin703094@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "LEE HEALTH SYSTEM INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.