Susan A Distasio, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

064077-23 Issued in NH

Practice address

One Medical Center Drive
Dartmouth Hitchcock - Pain Medicine/Anesthesiology
Lebanon, NH 03756-0001

Phone

(603) 650-6039

NPI assigned

Jun 29, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdistasio61251@direct.dartmouth-hitchcock.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

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.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Medicare reassignment NPD
• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  Medicare reassignment
• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1316975469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DARTMOUTH HITCHCOCK - PAIN MEDICINE/ANESTHESIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DARTMOUTH HITCHCOCK - PAIN MEDICINE/ANESTHESIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTASIO",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "064077-23",
            "primary": true
        },
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "CT",
            "license": "001896",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4196368",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Dilosa, DO
• Vida Maria Dinsdale, CRNA
• Mary Beth Dinulos, MD
• Felicia Dipietro, MSW PSYD
• Anthony W Discipio, M.D.
• Prashanthi Divakar, MD
• Laura Divirgilio
• Betty Dixon, MSW
• Peter Dixon, PA
• Tessa Dawn Dixon, RN

• Nurse Practitioner in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.