Vincent F Destasio, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB51894 Issued in NJ

Practice address

1851 Hooper Ave
Sta
Toms River, NJ 08753-8150

Phone

(732) 255-6566

Fax

(732) 255-3085

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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

• Family Walk-in, LLC

  • Family Medicine Physician
  • Howell, NJ
  • NPI 1598969719
  NPD (past) Authorized official
• Hackensack Meridian Health Medical Group - Primary Care PC

  • Family Medicine Physician
  • Red Bank, NJ
  • NPI 1336203538
  NPD (past)
• Jersey Shore Monmouth Family Medicine Group P C

  • Family Medicine Physician
  • Freehold, NJ
  • NPI 1760438030
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1043215650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 HOOPER AVE",
            "address_2": "STA",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538150",
            "telephone_number": "732-255-6566",
            "fax_number": "732-255-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 HOOPER AVE",
            "address_2": "STA",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538150",
            "telephone_number": "732-255-6566",
            "fax_number": "732-255-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTASIO",
        "first_name": "VINCENT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB51894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "D04846300",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5453208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Derrick, MD
• Akhilesh S Desai, MD
• Dilip N Desai, M.D. PA
• Desio Pain Institute P.a.
• Laurence R Desrochers, MD
• Robert K Destefano, ATC
• Kimberlee Devaney
• Paige Devecka, PMHNP BC
• Matthew Dever, MD
• Teena Dhakal, NP

• Family Medicine Physician in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.