Individual provider Active NPI

Jessica Lynn Hinaman Destefano

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1093344970
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2025-01754 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-2648
Phone
(336) 716-2255
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 2025-01754 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-2648

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010000121 NC Practitioner - Diagnostic Radiology 7113336090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians
Wake Forest Baptist Imaging LLCGroup PAC ID 3173681681, 76 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

1814 Westchester Dr
Suite 100
High Point, NC 27262-7369
Phone (336) 802-2175

265 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone (336) 765-5722

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047
  • High Point Regional Health System Hospital, High Point, NC, CCN 340004
  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025-01754NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Aug 22, 2025 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Aug 22, 2025 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jul 17, 2025 Accepting new patients
Wake Forest Health Network LLC Diagnostic Radiology CurrentSince Jul 17, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 17, 2025 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients

Locations

223 W Ward St
Ste B
Asheboro, NC 27203
Phone (336) 702-1731

223 W Ward St
#B
Asheboro, NC 27203

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

1814 Westchester Dr
Ste 100
High Point, NC 27262
Phone (336) 802-2397

861 Old Winston Rd
Ste 105
Kernersville, NC 27284
Phone (336) 765-5722

250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: jhinaman2756030@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1093344970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271572648",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINAMAN DESTEFANO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2025-01754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.