Brooke Distefano, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

3413 Issued in CO

Practice address

7800 E Orchard Rd
Suite 100
Greenwood Village, CO 80111-2583

Phone

(303) 697-7463

Fax

(303) 783-1200

NPI assigned

Nov 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brookedistefano@occllc.allscriptsdirect.net

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.

• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502
  NPD
• David Wong Spine PC

  • Orthopaedic Surgery of the Spine Physician
  • Greenwood Village, CO
  • NPI 1205194305
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1124001649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 E ORCHARD RD",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112583",
            "telephone_number": "303-697-7463",
            "fax_number": "303-783-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 E ORCHARD RD",
            "address_2": "SUITE 100",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112583",
            "telephone_number": "303-697-7463",
            "fax_number": "303-783-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "BROOKE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "3413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Dingler, COTA
• Staci Dingus, DDS
• Michael Dinneen, LCSW
• Amy Diane Diorio, CRNA
• Jon Gordon Dishler, MD
• Marguerite Distel, RN
• Sydney Celeste Dittman
• Karin Dittrick-Nathan, PHD
• Barb Divver, MT
• DKL Ventures, LLC

• Surgical Physician Assistant in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.