Judy A Distefano, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

2161 Issued in OK

Practice address

9423 E 95TH CT
Tulsa, OK 74133-5805

Phone

(918) 496-2400

Fax

(918) 496-2436

NPI assigned

Apr 11, 2006

Last updated

Oct 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ctca Physicans Group of Oklahoma, Inc

  • Specialist
  • Tulsa, OK
  • NPI 1053309591
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1023071826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9423 E 95TH CT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335805",
            "telephone_number": "918-496-2400",
            "fax_number": "405-948-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9423 E 95TH CT",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335805",
            "telephone_number": "918-496-2400",
            "fax_number": "918-496-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "JUDY",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "2161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphne Dinsmore, RN
• Ndeye Dione
• Julie Ann Dionne, D.O.
• Direct Medical Imaging LLC (Direct Diagnostic Imaging)
• Audie Dison
• Ronald Francis Distefano, D.O.
• Samantha Dittmer
• Julianna Whiteley Dittus
• John R Diver, O.D.
• Byron Conrad Dixon Jr.

• Anesthesiology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.