Organization Active NPI

Treasure Coast Wound Care LLC

  • Family Nurse Practitioner
  • Port Saint Lucie, FL
National Provider Identifier
1972318368
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TREASURE COAST WOUND CARE LLC
Practice address
1801 SW Castinet LN
Port Saint Lucie, FL 34953-1563
Phone
(772) 444-7546
NPI assigned
Feb 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Michelle Gozar, APRNNPI 1811480437
Title
Owner
Phone
(772) 444-7546

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 Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1801 SW Castinet LN
Port Saint Lucie, FL 34953-1563

Mailing address

1801 SW Castinet LN
Port Saint Lucie, FL 34953-1563
Phone (772) 444-7546

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250521003747 FL Part B Supplier - Clinic/Group Practice 9931628054 Receives reassigned benefits from 2 practitioners
Practice locations: Port Saint Lucie, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1972318368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SW CASTINET LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531563",
            "telephone_number": "772-444-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SW CASTINET LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531563",
            "telephone_number": "772-444-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "GOZAR",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-444-7546",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "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 Feb 11, 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.