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JORGE MANUEL GOMEZ VIZCARRA MD
NPI 1366911471
General Practice in Port St Lucie, FL

Active since November 19, 2018PECOS EnrolledAccepts Medicare Assignment
1100 SW SAINT LUCIE WEST BLVD STE 209, PORT ST LUCIE, FL 34986(772) 204-8889(772) 204-8895 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 28, 2025, Jul 19, 2021, Nov 19, 2018 (3 updates tracked since 2018).

About Jorge Manuel Gomez Vizcarra Md NPPES

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

JORGE MANUEL GOMEZ VIZCARRA MD (NPI 1366911471) is an individual general practice provider in Port St Lucie, Florida, licensed in Florida (ACN1356) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Port Saint Lucie, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1366911471
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameJORGE MANUEL GOMEZ VIZCARRACredential: MD
Location Address1100 SW SAINT LUCIE WEST BLVD STE 209Port St Lucie, FL 34986-1735
Mailing Address5400 Pinehurst DrSpring Hill, FL 34606-3833 · (352) 277-5348 · Fax (352) 606-2857
Phone(772) 204-8889
Fax(772) 204-8895
Sole ProprietorYes
Medical School CMSOtherGraduated 1981
Enumeration DateNovember 19, 2018
Last NPPES UpdateMarch 28, 20253 updates tracked since enumeration
NPPES CertifiedMarch 28, 2025
✔ NPI 1366911471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in FL · ACN1356✔ Licensed in PR · 21111
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
1100 SW SAINT LUCIE WEST BLVD STE 209, Port St Lucie, FL 34986
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Secondary Practice Location 1

Location 11801 SE Hillmoor Dr Ste A-109Port Saint Lucie, FL 34952-7545 · Phone (772) 212-7049 · Fax (772) 212-7059

Other Identifiers 1

Medicaid111375300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jorge Manuel Gomez Vizcarra Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244635662
PECOS Enrollment IDI20210824001388
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SADAF HAFEEZ MD
Internal Medicine
1100 SW SAINT LUCIE WEST BLVD STE 209
PORT ST LUCIE, FL 34986
St. Lucie County (772) 204-8889
TC PHYSICIANS LLC
Clinic/Center (Primary Care)
1100 SW SAINT LUCIE WEST BLVD STE 209
PORT ST LUCIE, FL 34986
St. Lucie County (772) 204-8889

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 Jorge Gomez Vizcarra's NPI number?

The NPI number for Jorge Gomez Vizcarra is 1366911471. It was assigned to this individual provider in the NPPES registry on November 19, 2018.

Where is Jorge Gomez Vizcarra located?

Jorge Gomez Vizcarra practices at 1100 SW Saint Lucie West Blvd Ste 209, Port St Lucie, FL 34986. The listed phone number is (772) 204-8889.

What is Jorge Gomez Vizcarra's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jorge Gomez Vizcarra enrolled in Medicare?

Yes. Jorge Gomez Vizcarra is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jorge Gomez Vizcarra accept?

Health plans from UnitedHealthcare list Jorge Gomez Vizcarra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jorge Gomez Vizcarra was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.