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JEFFREY L WISNICKI MD
NPI 1154406080
Surgery - Plastic and Reconstructive Surgery in Loxahatchee, FL

Active since October 26, 2006PECOS Enrolled
13005 SOUTHERN BLVD SUITE 133, PALMS WEST MEDICAL MALL ONE, LOXAHATCHEE, FL 33470(561) 798-1400(561) 798-0255 Get Directions Write a Review

NPPES record last updated: February 20, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jeffrey L Wisnicki Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY L WISNICKI MD (NPI 1154406080) is an individual plastic and reconstructive surgery provider in Loxahatchee, Florida, licensed in Florida (ME48094) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Stanford University School Of Medicine (1980).

NPPES Registry Identity

NPI1154406080
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameJEFFREY L WISNICKICredential: MD
Location Address13005 SOUTHERN BLVD SUITE 133, PALMS WEST MEDICAL MALL ONELoxahatchee, FL 33470
Mailing Address13005 Southern Blvd Ste 133, Palms West Medical Mall OneLoxahatchee, FL 33470-9231 · (561) 798-1400 · Fax (561) 798-0255
Phone(561) 798-1400
Fax(561) 798-0255
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 1980
Enumeration DateOctober 26, 2006
Last NPPES UpdateFebruary 20, 2013
✔ NPI 1154406080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in FL · ME48094
Definition
A surgeon who specializes in plastic and reconstructive surgery.
13005 SOUTHERN BLVD SUITE 133, Loxahatchee, FL 33470
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINA50224
Medicare ID-Type Unspecified61519

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey L Wisnicki Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183662034
PECOS Enrollment IDI20050420001231
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Wisnicki reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Jeffrey Wisnicki, M.D., P.A.
Same address
Plastic and Reconstructive Surgery
13005 SOUTHERN BLVD, SUITE 133
Loxahatchee, FL 33470
  • Reassigned Medicare billing, Florida enrollment
NPI 1265865471 (561) 798-1400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Wisnicki's NPI number?

The NPI number for Jeffrey Wisnicki is 1154406080. It was assigned to this individual provider in the NPPES registry on October 26, 2006.

Where is Jeffrey Wisnicki located?

Jeffrey Wisnicki practices at 13005 Southern Blvd Suite 133 Palms West Medical Mall One, Loxahatchee, FL 33470. The listed phone number is (561) 798-1400.

What is Jeffrey Wisnicki's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Jeffrey Wisnicki enrolled in Medicare?

Yes. Jeffrey Wisnicki is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeffrey Wisnicki's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Wisnicki reassigns Medicare benefits to Jeffrey Wisnicki, M.D., P.A. (Loxahatchee, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeffrey Wisnicki's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jeffrey Wisnicki was last updated on February 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.