Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jessica Marie Polutchko, PA-C

Individual provider Physician Assistant · NPI 1750065942

Jessica Marie Polutchko, PA-C is a Physician Assistant in Port St Lucie, Florida. Qualified in 2023, 3 years ago. Practices with Martin Memorial Medical Center Inc, a 516-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10080 SW Innovation Way Ste 201
Port St Lucie, FL 34987-2129
Phone: (772) 345-8100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3801 S Kanner Hwy, Stuart, FL 34994-4801 — (772) 223-4999

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9117407 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 9117407 (FL)

Record details

NPI number1750065942
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 9, 2023
Last updated in NPPESDecember 11, 2025
Certification dateDecember 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Martin Memorial Medical Center Inc — 516 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Port St Lucie