Coastal Care and Wellness PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

COASTAL CARE AND WELLNESS PLLC

Practice address

2100 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-8057

Phone

(561) 262-8785

NPI assigned

Aug 11, 2025

Organization subpart

No

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

Authorized official

Name

Jennifer M Qadir, PA-CNPI 1639470347

Title

PA-C

Phone

(772) 303-3011

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Jennifer M Qadir, PA-C

  • Physician Assistant
  • Port St Lucie, FL
  • NPI 1639470347
  Medicare reassignment Care Compare group NPD Authorized official
• Briannon Bebble, PA-C

  • Physician Assistant
  • Port St Lucie, FL
  • NPI 1326461617
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1760367452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "772-303-3011",
            "fax_number": "800-878-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE HILLMOOR DR STE 101",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349528057",
            "telephone_number": "561-262-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CARE AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "QADIR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "772-303-3011",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.