JACK MONROE VISCA
NPI 1710829742
Physician Assistant - Surgical in Crossville, TN
About Jack Monroe Visca NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK MONROE VISCA (NPI 1710829742) is an individual surgical provider in Crossville, Tennessee, licensed in Tennessee (7121) and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS, is affiliated with Cumberland Medical Center, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jack Monroe Visca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cumberland Medical Center
Acute Care Hospitals · Crossville, TNOther Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jack Visca's NPI number?
The NPI number for Jack Visca is 1710829742. It was assigned to this individual provider in the NPPES registry on April 8, 2026.
Where is Jack Visca located?
Jack Visca practices at 49 Cleveland St Ste 350, Crossville, TN 38555. The listed phone number is (931) 459-7720.
What is Jack Visca's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Jack Visca enrolled in Medicare?
Yes. Jack Visca is registered in the Medicare PECOS enrollment system.
Is Jack Visca affiliated with any hospitals?
According to CMS data, Jack Visca is affiliated with Cumberland Medical Center.
When was this NPI record last updated?
The NPPES record for Jack Visca was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jack Monroe Visca · NPI 1710829742
Surgical physician in Crossville, Tennessee. Individual provider, active in the CMS NPPES registry since April 8, 2026.
## Identity
- **NPI:** 1710829742 (Entity type: Individual)
- **Enumerated:** April 8, 2026
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 7121 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 49 CLEVELAND ST STE 350, Crossville, TN 38555-2898
- **Phone:** (931) 459-7720
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** May 4, 2026
- **Other identifiers:** Medicaid Q112201 (TN)
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Source: [NPI Profile](https://npiprofile.com/npi/1710829742) · Data from the CMS NPPES public registry.