John Destefano, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO 3715 Issued in FL

Practice address

1585 3Rd St
Fort Polk, LA 71459-5102

Phone

(337) 531-3427

NPI assigned

Jun 23, 2008

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johndestefano@nslijmedgr.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.

• Foot and Ankle Care of the Island Coast PA

  • Podiatrist
  • Fort Myers, FL
  • NPI 1750437166
  Medicare reassignment NPD
• Emerald Coast Hospitalist Inc

  • Hospitalist Physician
  • Panama City, FL
  • NPI 1144548793
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1124289111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W",
            "address_2": "SUITE 340",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "337-531-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 3715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Patrick Delgado, DDS
• Pablo Antonio Delis, MD
• Carolyn Delrie, RN
• Elizabeth McCarthy Depavloff, MD
• Gregory Derose Jr., DDS
• Raymond James Devlin III, MSN, CRNA
• Agostino Stephen Diroma, PA-C
• Hanna Divello, RD
• Morkisha Dobard, PHARM.D.
• Deana Ann Dougherty, LCSW

• Podiatrist in Fort Polk, LA
• Providers in Fort Polk, LA by specialty
• Podiatrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.